RESULTS: Current OC users differed from non-users on several factors. Current users were younger, had a lower mean body mass index (BMI), lower smoking prevalence, lower parity, and higher mean total cholesterol at all exams. By year 7, current users were more highly educated and by year 10 current users were more likely to be white and were more physically active than non-users. In unadjusted analyses, current use was associated with lower fasting glucose levels [À4.9 mg/dl, 95% CI (À5.7, À4. PURPOSE: Advanced lung cancer is a disease with little hope of long term survival. The two treatment options for patients are chemotherapy or supportive care. Several factors may influence the decision to undergo treatment. One poorly understood factor is the influence of a patient's faith on how they make medical decisions. We compared the effect of faith on treatment decisions among doctors, patients (PTs) and their caregivers (CGs). METHODS: 100 PTs with newly diagnosed advanced (stage IIIB) or metastatic (stage IV) lung cancer, their CGs, and 257 medical oncologists were interviewed separately using a standardized questionnaire. Participants were asked to rank, from 1 to 7, the factors that influenced their treatment decisions: (1)cancer doctor's recommendation, (2)faith in God, (3)ability of treatment to cure disease, (4)side effects, (5)family doctor's recommendation, (6)spouse's recommendation, (7)children's recommendation. Rankings were compared between the 3 groups of participants using restricted simultaneous ordered logistic regression models. Comparisons between those PTs who ranked faith as a high priority (1 or 2), and those PTs who ranked faith as a low priority (3 ± 7), were made using t-tests and chi-square tests. RESULTS: All 3 groups ranked the oncologist's recommendation as the most important factor. However, PTs and their CGs ranked faith in God second, while physicians placed it last (p < 0.001). The ability of the treatment to cure disease and side effects were important to all groups. PTs and CGs ranked their family doctor, spouse or child's recommendation as less important. Physicians were generally in agreement with PTs and CGs with the exception of physicians feeling the spouse's input was more important than did the PTs or CGs. PTs who placed a high priority on faith in God (n=53) were more likely to be African American (40% vs. 19%; p < 0.05). Irrespective of race, PTs who placed a high priority on faith in God were less likely to have graduated high school than those who ranked faith lower (47% vs. 72%; p < 0.001). There was a trend for PTs who ranked faith high to leave all decisions regarding treamtent to their oncologist. CONCLUSION: PTs and CGs are in complete agreement on the factors that are important in deciding on treatment options for advanced lung cancer but differ substantially from doctors. All 3 agree that the single most important factor is the oncologists's recommendation. However, faith in God is an extremely important factor for PTs and CGs but not physicians. PTs who ranked faith high are disproportionately African American and less likely to have graduated high school. Medical decision making incorporates tangible probabilities and utilities, (i.e. morbidity, mortality, side effects and costs of differing treatment options), into decision models that aid in a patient's treatment choice. This study suggests the previous model of decision making may be oversimplified. To our knowledge this is the first study to demonstrate that, for some, faith is an extremely important factor in medical decision making, more so than even the efficacy of treatment. If faith plays an important role in how some PTs decide treatment, and physicians are unaware of or do not account for it, the decision making process may be unsatisfactory to all involved. Future studies should clarify how faith impacts on individual decisions regarding treatment. Alcohol consumption decreased in all treatment arms. The 77 subjects (36%) who sustained a 30% decrease in drinks/month from baseline through 12 months had significant improvement in the SF-36 Mental Component Summary score (P = 0.037) and Physical Component Summary score (P = 0.058) and had fewer alcohol-related consequences (P < 0.001) when compared to those who did not sustain a decrease. In addition, the 34 subjects who sustained a decrease to non-hazardous levels (defined as < 16 drinks/week for men and < 12 drinks/ week for women) through 12 months had significant improvement in the SF-36 Physical Component Summary score (P = 0.002) and had fewer alcohol-related consequences (P = 0.047) when compared to those who continued a hazardous level of use. CONCLUSION: Outpatient problem drinkers who sustain a reduction in alcohol consumption have improved health-related quality of life and fewer alcohol-related adverse consequences. Benefits are seen across a wide spectrum of alcohol problems. These findings provide additional motivation for primary care physicians to identify patients with alcohol problems and to initiate intervention. Our overall response rate was 34.6%. We found that over half of the residents who responded had ever fallen asleep while driving, and 21.9% of respondents were involved in an automobile accident during residency. Over half of the respondents had received a moving violation, most often for driving fast and driving to or from clinic or the office. There was no correlation between frequency of call and hours of sleep to incidence of motor vehicle accidents and receiving a citation; however, there was a higher incidence of falling asleep while driving in patients who were on call every third night and slept fewer than four hours a night (p = 0.001 for both). If they did have an accident, it was most likely on a post-call day returning from the hospital. 89.9% of the residents got four or fewer hours of sleep on a typical on-call night. CONCLUSION: Residents-in-training are at high risk for motor vehicle accidents and falling asleep while driving when they are post-call and have less sleep. Mechanisms for reducing resident fatigue post-call such as a night-float system may reduce these incidences. . Descriptive statistics, t-tests, and ANOVA (SPSS version 10) were used to describe the population and determine associations between the variables of interest. RESULTS: 66/82 (80%) individuals from 14 PoPCRN sites consented to and were able to participate. 56% were female, 89% were white, 39% were cared for at home, and 53% had a cancer diagnosis. The median age was 76 years, median Karnofsky score 50%, and median time between hospice admit and interview was 49 days. MQOL responses (range 0 ± 10; 0=bad, 10=good) indicate that these patients had few physical symptoms, but the ones they had were problematic (single troublesome symptom score=4.4). The MQOL subscale scores indicate that these patients were less troubled by psychosocial and existential issues than by physical symptoms: Total MQOL score=7.1, Physical well-being score=6.0, Physical symptom overall score=5.9, Psychological symptom score=7.1, Existential well-being score=7.4, Support score=8.6. There were no significant associations between age, marital status, gender or length of hospice care and any of the QOL scores. A Karnofsky score < 50% was associated with worse Existential well-being (6.9 vs. 7.9, p=0.017) while a cancer diagnosis was associated with greater Existential well-being (7.8 vs. 6.9, p=0.047). Being cared for at home and a cancer diagnosis were both associated with a greater sense of Support ( From pharmacy data, we categorized the type of prescribed ART for > 50% of treatment time in each year into 4 intensity levels: none; 1 ART; 2+ ART but not highly active ART (HAART); or HAART including a protease inhibitor or non-nucleoside reductase inhibitor. Changes in ART from the base year to the next were classified as: suboptimal (ie, continuing or increasing to 1 ART or changing from a more intense to a less intense regimen); acceptable (ie, continuing or increasing to 2+ non-HAART drugs); or optimal (ie, continuing or increasing to HAART). Indicators were also created for visits (N=0, 1 ± 3, 4+) to a provider with a NYS contract to offer HIV-focused care in exchange for higher Medicaid payment. Each patient's outpatient care pattern in the base year was categorized as: regular medical care alone ( > 35% of visits to one provider); regular substance abuse treatment alone (6+ months with one provider); both; or neither. We estimated ordinal logistic regression models of ART pattern corrected for clustering of observations. RESULTS: Temporal changes in ART were: suboptimal (44%), acceptable (20%), and optimal (36%). Adjusted odds ratios (AOR) of greater intensity of ART were higher for persons with PURPOSE: Patients with limited English proficiency who are seen by language discordant providers may communicate through a variety of interpretation methods. We studied the effect of translation method on satisfaction among Spanish-speaking patients at a hospital-based walkin clinic serving primarily indigent patients. METHODS: All Spanish-speaking patients and a random selection of 10% of English-speaking patients presenting to the walk-in clinic at Denver Health Medical Center between July and October 2000 were approached for study entry. Participants completed a self-administered post-visit questionnaire assessing demographics, general health, and satisfaction with clinic visit.`L anguage concordant'' patients were defined as Spanish-speaking patients seen by Spanishspeaking providers and English-speaking patients. These patients were compared with`l anguage discordant'' patients who used AT&T interpreters, family, or other interpreters for translation. Patients were considered``satisfied'' if they rated their satisfaction as very good or excellent. Evaluation of satisfaction was by multiple logistic regression, controlling for age, sex, race, language spoken, education, and health. RESULTS: Of the 536 study participants, 67% were Spanish-speaking. Among Spanishspeaking patients, 42% were seen by language concordant providers. For patients who did not see language concordant providers, translation was through ATT telephone interpreters (19%), family members (23%), and other interpreters (16%). Language concordant and language discordant participants did not differ in age, sex, race, insurance status, or education level. Language concordant patients were less likely to be Hispanic (59% vs 95%, p=0.001) or describe their health as poor or fair (29% vs 51%, p=0.001). Language concordant patients and patients using ATT telephone interpreters reported identical overall visit satisfaction (77%), while patients using family or other interpreters were significantly less satisfied (54% and 49%, p < 0.01 and p=0.007, respectively). Compared to language concordant patients, patients who had family members translate were less satisfied with their provider in regards to listening to health concerns (62% vs 85%, p=0.003) and discussing sensitive issues (60% vs 76%, p=0.02). Patients who used other interpreters were less satisfied with provider skills (60% vs 83%, p=0.02), manners (71% vs 88%, p=0.02), listening (54% vs 85%, p=0.002), explanations (57% vs 84%), p=0.02), answers (57% vs 84%, p=0.05), and support (63% vs 84%, p=0.02). CONCLUSION: Patients utilizing less formal translation methods, such as family members and ad hoc interpreters, are less satisfied with care than those seeing language concordant providers or using AT&T telephone interpretation. METHODS: Women ages 35 ± 50 without a history of breast cancer were recruited from the waiting room of a university internal medicine practice. Following a baseline questionnaire about breast cancer risk factors, and benefits/harms of mammography, 179 women were randomized to one of three videos. For women ages 40 ± 49 who undergo 10 years of mammography, the videos described the number of lives extended(1/1000), the number of false positives expected(300/1000), and the number of women expected to worry after a false positive mammogram screening(100/1000). Information was numerically equivalent in each video but presented in a positive frame(1 woman would have her life extended) a negative frame(999 women would not have their lives extended) or a balanced frame(positive and negative information given). Participants completed a follow-up questionnaire immediately after viewing the video. RESULTS: Participants were predominately insured(80%), white(60%) and high school graduates(63%). At baseline, 3% endorsed the correct response(1 per 1000 women screened for 10 years would live longer because they had mammograms) and 76% thought 100 or 500 women would live longer. After the video, 53% endorsed the correct response with no differences by video (p=.21). For the number of false positives expected, 15% gave the correct response at baseline, but at followup the correct responses were given by more women in the negative(65%) and balanced(65%) frames than in the positive frame(40% P < .01). The results were parallel for the number expected to worry after a false positive (62%,56%, and 32% for negative, balanced and positive frames respectively). A majority of respondents in all three groups thought the benefits of mammography were more important than the harms before(75 ± 80%) and after seeing the the video(77 ± 81%). CONCLUSION: Women's baseline knowledge of the benefits of mammography was overly optimistic. All three videos improved women's knowledge of the benefits/harms of mammography. Despite this improvement in knowledge and exposure to varying frames of information, women's perceptions of the benefits/harms did not change. To determine if``numeracy '' affects women's ability to learn information about the potential benefits and harms of mammography. METHODS: In the waiting room of a university internal medicine practice we recruited 179 women ages 35 ± 50 without a history of breast cancer and randomized them to one of three videos. For women ages 40 ± 49 who undergo 10 years of mammography, the videos described the number of lives extended(1/1000), the number of false positives expected(300/ 1000), and the number of women expected to worry after a false positive mammogram screening(100/1000). Participants completed a questionnaire immediately after viewing the video. Information presented in each video was numerically equivalent, but to obtain the correct answers, subtraction was required for at least one question in each video. Numerate women were defined as being able to correctly note that 40% was equivalent to a 4 out of 10 chance. RESULTS: Participants were predominately insured(80%), white(60%), high school graduates(63%), and over half were numerate(65%).The table shows the percentage of correct responses for numerate and non-numerate women when the answers were given in the video compared to when subtraction was required to get the correct answers.