Medicine and Health Sciences Commons^™

Building Health Equity One Institution At A Time: The Research Infrastructure In Minority Institutions Project, Laura H. D'Anna, Dennis G. Fisher, Lyka Eunice F. Trinidad, Carol Canjura, Jefferson L. Wood

Journal of Health Disparities Research and Practice

Developing a well-trained workforce interested in, and prepared for, conducting health equity research is an important national priority. Scientists from Minority-Serving Institutions (MSIs) bring unique perspectives and experiences with racial, ethnic and social inequities in health and health status but often lack access to training and mentoring opportunities, which is crucial for increasing the diverse pool of investigators who are adequately prepared to conduct health disparities research and to compete for National Institutes of Health research funding. The focus of the California State University, Long Beach (CSULB) Research Infrastructure in Minority Institutions (RIMI) Project was to: (a) enhance CSULB’s infrastructure …

"Courage 2 Test": An Evaluation Of A Social Media Marketing Campaign To Increase Hiv Testing Among Young Black Men, Jamal T. Jones, Laura F. Salazar, Richard A. Crosby

Journal of Health Disparities Research and Practice

The purpose of this study was to evaluate a social media marketing (SMM) campaign designed to increase HIV testing among young Black men attending a public university in Atlanta, GA. “Courage 2 Test” was a three-month SMM campaign (launched from February 2017 to April 2017) that included targeted Facebook and Instagram advertisements to encourage HIV testing. Students completed an online survey via two cross-sectional samples (n=106 at baseline and n=98 post campaign). Campaign evaluation involved assessing the effects of campaign exposure and the pre/post-grouping variable on ever testing for HIV and testing for HIV in the previous six months via …

“You Come Back To The Same Ole Shit:” A Qualitative Study Of Smoking Cessation Barriers Among Women Living With Hiv: Implications For Intervention Development, Faith E. Fletcher, Damon J. Vidrine, Meredith K. Buchberg Trejo, Yamile' Molina, Beverly E. Sha, Brenikki R. Floyd, Noreen Sarhene, Jamesetta Mator, Alicia K. Matthews

Journal of Health Disparities Research and Practice

Although tobacco use among women living with HIV (WLWH) is decreasing, the prevalence is more than double that of women in the general population and remains an important health behavior to target among WLWH. Few smoking cessation interventions specifically focus on the unique social and medical needs of women living with HIV (WLWH). Thus, the investigative team engaged WLWH (N=18) in qualitative focus groups to: 1) understand barriers and facilitators to smoking cessation; and 2) inform intervention structure and content priorities. Participants identified salient reasons for smoking and barriers to smoking cessation, which included coping mechanisms for life stressors, HIV-related …

Predictors And Missed Opportunities For Blood Glucose Screening Among African Americans: Implications For Church-Based Populations, Alexandria G. Bauer, Jannette Berkley-Patton, Carole Bowe Thompson, Kelsey Christensen

Journal of Health Disparities Research and Practice

African Americans (AAs) are disproportionately diagnosed with prediabetes, diabetes, and related complications. Guidelines for prediabetes/diabetes screening emphasize reaching at-risk adults. The AA church has potential to increase reach of BGS with AA church members and community members. The current study identified predictors of blood glucose screening (BGS) and individuals with missed opportunities for BGS among church-affiliated AA adults. Participants were drawn from a previous pilot study (Project Faith Influencing Transformation) conducted in six AA churches over eight months. Eligibility criteria included self-identifying as AA and being aged 18 or older. Participants who had previously been diagnosed with diabetes were excluded, …

Teaching About Cultural Competence And Health Disparities In An Online Graduate Public Health Course, Anuli Njoku, Drph, Mph, Uchenna Baker, Phd, Med

Journal of Health Disparities Research and Practice

The growing diversity in U.S. society encourages the need for culturally competent healthcare professionals to provide optimal services to a diverse population. This increasing diversity also brings greater awareness to health disparities among distinct subgroups of the U.S. population. Addressing health disparities in the USA will require a multidimensional approach from various sectors, including the field of education. Developing health disparities curricula can help cultivate conscious future health practitioners. Faculty development programs can be integral in equipping faculty to develop curricula on and teach students about health disparities. With a growth in online learning and in the number of adult …

Factors Associated With Participation In The Oregon Summer Food Program: A Mixed Methods Analysis, Alethea Chiappone, Teresa M. Garvin, Casey Blaser, Hollyanne E. Fricke, Lisa Weissenburger-Moser Boyd, Tom Barnard, Amy L. Yaroch

Journal of Health Disparities Research and Practice

The Summer Food Service Program (SFSP) was established to ensure children eligible for the National School Lunch Program (NSLP) continue to receive meals outside of the school year. However, participation in SFSP is relatively low (2.8 million annually) when compared with NSLP participation (30.4 million annually), suggesting that challenges exist in reaching children. Using a mixed methods approach, this study explored factors associated with SFSP participation. A secondary data analysis of the Oregon SFSP identified factors associated with SFSP participation at the Oregon SFSP-, sponsor-, and site-levels. Semi-structured interviews with SFSP sponsors explored barriers and facilitators to SFSP participation. Results …

Social Vs. Practical Problems In Attaining A Colonoscopy: Different Patient Profiles?, Barbara A. Curbow, Evelyn C. King-Marshall, Nora Mueller, Travis Hyams, Shahnaz Sultan, Thomas J. George Jr

Journal of Health Disparities Research and Practice

Background: Colonoscopy is an effective procedure for identifying precancerous polyps and cancerous lesions, but it is unlike other cancer screening tools in that it requires sedation and thus assistance from at least one other individual. The intent of this paper was to identify logistical problems in completing the colonoscopy and to examine their relationships with sociodemographic characteristics.

Methods: All eligible patients (n = 2500) from two academic-affiliated colonoscopy centers (one free standing, one hospital-based) were invited to participate in an onsite, pre-colonoscopy survey; patients agreeing to participate (n = 1841, RR = 73.6%) received a $5.00 gift card. Multiple correspondence …

Prescription Medication Misuse Among American Indians In The Midwestern Us, Charley S. Lewis, Jordyn Gunville, Ryan Goeckner, Brian Chase, Lauren Clark, Jianghua He, Won S. Choi, Christine M. Daley

Journal of Health Disparities Research and Practice

Background: Prescription medications, particularly opioids, are often abused rather than used as intended by the prescribing physician. This is well-documented, though little data are available on American Indians. Misuse of other prescription medications is far less documented, but does occur and can have wide-spread effects.

Methods: We used a cross-sectional survey of American Indians in the Midwestern US (N=361) to begin to understand misuse of prescription medications, not necessarily to get high, but for any reason. Participants were recruited for this touchscreen computer-based survey at powwows, health fairs, and other community events through a convenience sample. We asked questions …

Cancer Risk Factors And Screening Behavior Among Korean Americans In The Sf Bay Area, Nhayoung Hwang, Hyunju Kim, Eugenia Yoo, Denny Cha, Winston Tseng Phd, Susan L. Ivey Md, Mhsa

Journal of Health Disparities Research and Practice

Background: Korean Americans (KA) have the highest prevalence of death from cancer among Asian American ethnic groups in the U.S. This KA prevalence rate is also substantially higher than that of non-Hispanic whites, yet little is known about their cancer risk factors. This paper is one of the first studies to explore cancer risk factors and screening behaviors of Korean Americans in the San Francisco Bay Area.

Methods: A survey instrument was created using items from the California Health Interview Survey (CHIS) from 2009-2012, which were translated into Korean. A cross-sectional survey assessing the prevalence of cancer risk factors and …

Examining The Impact Of Race And Rurality On Health Differences Among Overweight Youth Accessing Pediatric Endocrinology Care, Kelsee Halpin, Janelle R. Noel-Macdonnell, Yun Yan

Journal of Health Disparities Research and Practice

Methods: This study examines the impact of race and rurality on health differences, including prevalence of prediabetes and type 2 diabetes (T2D), among overweight children accessing pediatric endocrine specialty care. Cross-sectional analysis of overweight/obese youth 10 to 18 years of age receiving pediatric endocrinology consultation for weight gain, hyperglycemia, and/or T2D from 2013 to 2016 at a Midwest tertiary pediatric center.

Results: The 722 patients were 42% white, 25% black, 22% Hispanic; 88% lived in urban areas and 12% in rural areas. Rurality was determined using zip code approximation of Rural-Urban Commuting Area (RUCA) codes. After adjusting for confounders, black …

Nutrient And Food Group Intakes Of Low-Income Pregnant Women By Race/Ethnicity, Alla M. Hill, Danielle L. Nunnery Phd, Rdn, Ldn, Alice Ammerman Drph, Jigna M. Dharod Phd

Journal of Health Disparities Research and Practice

In an exploratory study, a convenience sample of 148 pregnant women was recruited from a WIC clinic in the southeast region of the U.S. to: 1) Examine and compare daily nutrient and food group intakes of WIC pregnant women to national guidelines, and; 2) Determine racial/ethnic differences in nutrient and food group intakes among WIC pregnant women. Women were selected for the study if they were: ≥ 18 y, in 2^nd trimester of pregnancy, and if they spoke English or Spanish as a first language. Upon recruitment, participants were interviewed to collect information on their socio-demographics, including race/ethnicity. Additionally, …

Utilization Of Media-Driven Technology For Health Promotion And Risk Reduction Among American Indian And Alaska Native Young Adults: An Exploratory Study, Todd M. Sabato

Journal of Health Disparities Research and Practice

Across the developmental spectrum, American Indian and Alaska Native (AI/AN) adolescents and young adults experience considerable behavioral and mental health disparities, including substance abuse, depression, and engagement in sexual behaviors which enhance risk of pregnancy and sexually transmitted infections. Health-focused interventions utilizing digital and media technology hold significant promise among tribal communities, as they have the capacity to eliminate geography-based barriers. Utilizing a sample of 210 self-identified AI/AN students attending tribal colleges, this study identified the most effective technologies and intervention strategies, as well as health seeking patterns and preferences, which may impact implementation and sustainable use in tribal settings. …

Five-Year Trend In Diabetes Clinical Care And Self-Management Among Adults With Diabetes In West Virginia: 2010-2014, Ranjita Misra 2934168, Usha Sambamoorthi

Journal of Health Disparities Research and Practice

Objective: To examine the five-year trend in clinical care and diabetes self-management activities among adults living in the Appalachian state of West Virginia.

Methods: This study used a cross-sectional design with data from the Behavioral Risk Factor Surveillance System in 2010 (N=685) and 2014 (N=958), among noninstitutionalized adults with diabetes. Five-year trend in recommended diabetes clinical care, diabetes self-management activities and diabetes education was analyzed after adjusting for sex, education, income, insurance, age, obesity, comorbid hypertension, race and lifestyle behaviors (exercise and smoking).

Results: A significant increase in percentage of adults with 2 or more A1C tests was …

Native American Weight Loss Movement: Pilot Test Of A Culturally Tailored Weight Loss Program For American Indians, Christine M. Daley, Jason W. Hale, Shelley Bointy, Kelly Berryhill, Joseph Lemaster, Byron J. Gajewski

Journal of Health Disparities Research and Practice

American Indians (AIs) have higher rates of obesity than other racial/ethnic groups, placing them at heightened risk for cardiovascular diseases, diabetes, and certain cancers. Culturally appropriate weight loss interventions may be the key to reducing risk. The most successful program used in AI communities has been the Diabetes Prevention Program (DPP), which limits enrollment to individuals with a clinical diagnosis of pre-diabetes. The purpose of this pilot project was to modify and culturally tailor a weight loss intervention to AI communities in Kansas to improve weight loss related behaviors among those who do not qualify for the DPP. The Native …

Factors Influencing Healthy Eating Habits Among Low-Income African Americans In Tennessee, Kushal Patel, Jonathon Smith, Jemal Gishe 9637046, Mohamed Kanu, Rosemary Theriot, Jianguo Liu, Yuan Zhou, Margaret Hargreaves

Journal of Health Disparities Research and Practice

Introduction: Poor nutrition and diet are significant contributors to the development of chronic illnesses such as cancer and diabetes, particularly among individuals of lower socioeconomic status (SES).This study examined demographic and lifestyle factors that influenced decisions to engage in healthy eating behaviors among low-income African Americans in three urban Tennessee cities.

Methods: As part of the Meharry Community Networks Program (CNP) needs assessment, a 123-item community survey was administered to assess demographic characteristics and eating behaviors among low-income African Americans. The total sample size was 1116. The primary outcome of interest was the healthy eating habits score which was calculated …

Comparison Of Compliance With Cervical Cancer Screening Among Women Aged 18 And Above In Arkansas And The United States, Sarah N. O'Connor, Jun Tao, L. Joseph Su

Journal of Health Disparities Research and Practice

Introduction: Cervical cancer preys on women without access to preventative screening. Any woman who has developed an invasive case of cervical cancer should be regarded as a failure of screening. Disparities in access to screening, triage, and treatment fuel an uneven distribution in the burden of cervical cancer within the United States; weighing unusually heavy on the Southern States like Arkansas. The purpose of this study was to evaluate demographic and behavioral risk factors for cervical cancer and identify potential barriers which may influence the likelihood of complying with current Pap test recommendations on a state level, in Arkansas, and …

Who Speaks For Me?: Addressing Variability In Informed Consent Practices For Minimal Risk Research Involving Foster Youth, Mary V. Greiner, Sarah J. Beal, Antonio Allen, Vikash Patel, Jareen Meinzen-Derr, Armand Antommaria

Journal of Health Disparities Research and Practice

Background: Youth in protective custody (i.e., foster care) are at higher risk for poorer physical and mental health outcomes compared with those who are not. These differences may be due in part to the lack of research on the population to create evidence-based recommendations for health care delivery. A potential contributor to this lack of research is difficulties in obtaining informed consent for empirical studies in this population. The objective of this study was to describe the approaches to obtaining informed consent in minimal risk studies of foster youth and provide recommendations for future requirements.

Methods: We conducted a …

Racial Discrimination And Preterm Birth Among African American Women: The Important Role Of Posttraumatic Stress Disorder, Amelia Gavin, Nancy Grote, Kyaien Conner, Taurmini Fentress

Journal of Health Disparities Research and Practice

Among African American infants, preterm birth (PTB) is the most frequent cause of infant mortality. In the United States, there remains a stark African American-Non-Hispanic White difference in PTB (< 37 weeks of completed gestation). When compared to Non-Hispanic White infants, African American infants have greater than three times the risk of preterm-related mortality. Prior research studies have examined whether traditional prenatal risk factors explain the African American-Non-Hispanic White difference in PTB. However identification of these factors fails to explain the disparity. The lack of progress in addressing the African American - Non-Hispanic White difference in PTB suggests that exposures to risk factors across the life-course may be vital to addressing the African American-Non-Hispanic White difference in PTB. One potential life-course risk exposure is racial discrimination, which has been shown to influence the increased risk of PTB among African American women. However, research is needed to reveal the mechanisms that underlie the association between racial discrimination and PTB. Posttraumatic stress disorder (PTSD) may be one potential mechanism by which African American women's exposure to racial discrimination contributes to increased risk of PTB. This concept paper strives to advance our understanding of the increased risk of PTB among African American women. Recommendations are suggested to mitigate the impact of racial discrimination and PTSD on the PTB risk among African American women.

Exploring The Cultural Perceptions Of Physical Activity Among Transnational Nigerian Immigrants, Kelechi D. Ibe-Lamberts, Daudet Ilunga Tshiswaka, Abi Fapohunda

Journal of Health Disparities Research and Practice

Background: Transnational Nigerian Immigrants, as other Transnational African Immigrants, are a subset of African immigrants with the unique ability to sustain multi-national ties. These ties could potentially affect health behavior choices and participation in physical activity. Physical Activity has the potential to improve health and prevent chronic diseases; however, there is a lack of literature regarding physical activity and its determinants within the Transnational African Immigrant population in general. This study investigated the cultural factors that shape Transnational Nigerian Immigrants’ perceptions and attitudes towards physical activity.

Methods: Semi-structured, individual interviews supported by photo-elicitation were conducted on 24 Transnational …

Prehypertensive Risk Among African-American Undergraduates: Do The Extra Pounds Really Matter?, Cecile N. Yancu, Amber Debono, Anna K. Lee, Correll Mcrae, Daphne Witherspoon

Journal of Health Disparities Research and Practice

The objective of this study is to examine prehypertension among young African American adults and evaluate the predictive value of easily obtained standard measures of adiposity. Data for this study of 155 primarily African-American undergraduates was collected between April 2010-11. Participants provided family health history and anthropometric measures, including body weight, body mass index (BMI), and waist to hip (WHR) ratio. Percentages were calculated for demographics. The average systolic blood pressure measured over two time periods within a single semester generated prehypertension rates. Univariate and multivariate logistic regression examined the impact of BMI, WHR, weight, and family medical history on …

Disparities In Access To Primary Care And Emergency Department Utilization In A Large Medicaid Program, Natasha Parekh, Marian Jarlenski, David Kelley

Journal of Health Disparities Research and Practice

Identifying and eliminating disparities are priorities for State Medicaid programs, especially in the context of increased enrollment through Medicaid expansion. We assessed racial, ethnic, regional, and managed care organization (MCO) differences, as well as time trends before and after Medicaid expansion, in primary care and emergency department (ED) utilization in a large Medicaid program. We performed a cross-sectional evaluation of data from Pennsylvania Medicaid from 2011-2015. Three primary care outcomes included: 1) adult access to primary care; 2) adolescent access to primary care; and 3) pediatric access to dental care. Our fourth outcome reflected ED utilization. We observed significant racial …