Medicine and Health Sciences Commons^™

Association Between Depression And Aggression In Rural Women, Laetitia Meyrueix, Gabriel Durham, Jasmine Miller, K. Bryant Smalley Phd, Psyd, Jacob C. Warren Phd

Journal of Health Disparities Research and Practice

Rural women represent approximately 20% of women living in the United States, yet research on the specific mental health needs of rural women is limited. Given the well-recognized gender-linked disparity in depression, its correlated symptoms in women still need much investigation. While emerging notions of depression in men embrace potential symptoms related to irritability and aggression, less research has focused on the potential role of aggression in depressed women. This connection may be particularly relevant for rural women who face unique mental health stressors in comparison to their urban counterparts. The purpose of this study was to examine if aggression …

Attitudes Toward Breast Cancer Genetic Testing In Five Special Population Groups, Amelie G. Ramirez, Patricia Chalela, Kipling J. Gallion, Edgar Muñoz, Alan E. Holden, Linda Burhansstipanov, Selina A. Smith, Evaon Wong-Kim, Stephen W. Wyatt, Lucina Suarez

Journal of Health Disparities Research and Practice

Purpose: This study examined interest in and attitudes toward genetic testing in 5 different population groups.

Methods: The survey included African American, Asian American, Latina, Native American, and Appalachian women with varying familial histories of breast cancer. A total of 49 women were interviewed in person. Descriptive and nonparametric statistical techniques were used to assess ethnic group differences.

Results: Overall, interest in testing was high. All groups endorsed more benefits than risks. There were group differences regarding endorsement of specific benefits and risks: testing to “follow doctor recommendations” (p=0.017), “concern for effects on family” (p=0.044), “distrust of modern medicine” (p=0.036), …

Hawai‘I’S Caring Communities Initiative: Mobilizing Rural And Ethnic Minority Communities For Youth Suicide Prevention, Jane J. Chung-Do, Deborah A. Goebert, Kris Bifulco, Tasha Tydingco, Antonia Alvarez, Davis Rehuher, Jeanelle Sugimoto-Matsuda, Bridget Arume, Pohai Wilcox

Journal of Health Disparities Research and Practice

Youth suicide is a serious, yet preventable, public health concern for ethnic minorities and rural communities. This paper describes the youth leadership model utilized by Hawai‘i’s Caring Communities Initiative (HCCI) and provides reflections on the important factors for success in implementing a youth and community advocacy project for youth suicide prevention. HCCI partnered with six youth and community organizations who serve ethnic minority and rural communities across the State of Hawai‘i to train youth leaders and community members in suicide prevention, in order to develop community awareness activities that are grounded in each community’s strengths and needs. The work of …

Epidemiology Of Hiv Among American Indians And Alaska Natives – United States, 2008-2011, Frances J. Walker, Jane M. Kelly, Mona Doshani, Neeraja Saduvala, Joseph Prejean

Journal of Health Disparities Research and Practice

American Indians/Alaska Natives (AI/AN) diagnosed with HIV infection have poorer survivorship and a higher percentage of Stage 3 (AIDS] diagnoses within one year of HIV diagnosis, compared to most race/ethnicity groups. National HIV surveillance data for 2008-2011 were used to determine diagnosis rates of HIV infection, persons living with HIV, and persons with a late diagnosis (Stage 3 within three months of HIV diagnosis) by selected characteristics for AI/AN and a combined other race/ethnicity group. The highest percentages of 862 AI/AN diagnosed with HIV infection were among males (75.7%), AI/AN aged 25-34 years (32.9%), persons living in large metropolitan areas …

Racial Disparities In The Association Between Stress And Preterm Birth, Saba W. Masho, Sarah Kye Price, Patricia Anne Kinser, Nancy Jallo

Journal of Health Disparities Research and Practice

Background: High levels of maternal stress have been linked to preterm births. However, findings from previous studies are inconsistent due to the varied use of stress measures. This study examined the effect of maternal stress on preterm birth, using both psychosocial and physiological measures.

Methods: This study was conducted among 231 pregnant women enrolled during their first prenatal care visit. Presence of stress was assessed at enrollment using the Perceived Stress Scale (PSS) and Stressful Life Events Inventory (SLEI). Samples of maternal salivary cortisol were obtained during the first trimester and birth outcomes were ascertained at delivery. Multiple …

"There’S More To Us Than This:" A Qualitative Study Of Black Young Adults’ Perceptions Of Media Portrayals Of Hiv, Maya Corneille, Anna Lee, Roseina Britton, Judith C. Barker

Journal of Health Disparities Research and Practice

The extent to which the targeted group attends to and is engaged by HIV/STI prevention messages is one component of effective health communication. Through an empirical examination of the cumulative perceptions of HIV/STI prevention media messages targeted to Black youth and young adults, this qualitative study privileges the voices of Black/ African American young adults as a group that is frequently targeted in HIV prevention campaigns. Semi-structured interviews with 23 Black/African American young adults yielded key themes that suggest barriers to effective health communication. Traditionally, health promotion has advocated for targeted messages as a means to increase risk perception and …

Community Based Participatory Research: The Application And Lessons Learned From A Study With Lgb College Students, Caitlin M. Stover

Journal of Health Disparities Research and Practice

Lesbian, gay, and bisexual (LGB) individuals are members of a vulnerable group where health disparities have been identified. To gain a better understanding of the LGB college student healthcare experience and its contribution to the healthcare disparities found in LGB population, a community based participatory research (CBPR) approach was used to fill the gap. This paper will outline the CBPR process with an emphasis on how the principle investigator applied the tenets of CBPR when working with a local LGB college community. Several lessons learned from the research process are also shared in this paper.

The Role Of Trauma In Disparities For Cancer-Related Health: A Call To Action, Megan Bair-Merritt

Journal of Health Disparities Research and Practice

Cancer is the second leading cause of death in the United States. In this brief report, we describe the current literature on interpersonal trauma (i.e., sexual abuse and intimate partner violence) and cancer. Concordant with the general population, between 20% and 50% of cancer patients have experienced interpersonal trauma. Experiences with interpersonal trauma not only appear to increase risk for developing cancer, but may also act as a roadblock to accessing appropriate preventive testing and to receiving adequate support during cancer care. Healthcare providers can play an important role in making cancer-related care more trauma-informed.

Understanding How Components Of Black Racial Identity And Racial Realities May Impact Healthcare Utilization: A Randomized Study, Alexander M. Chaitoff, Thomas Wickizer, Ismail White

Journal of Health Disparities Research and Practice

Purpose: Studies have suggested that even when minority groups have potential access to healthcare, they may have inadequate utilization (realized access). This study explores the application of a theory from the social psychology and political science literatures concerning how racial centrality and racial realities, specifically amongst Blacks, may influence patients’ healthcare utilization preferences.

Methods: We created a survey with two (pseudo) randomized, controlled experimental treatments designed to assess whether racialized hospital and physician characteristics elicited a preference from Black or White respondents, as well as questions aimed at understanding participants’ different beliefs and levels of knowledge about past and current …

Social Determinants Of Late Stage Hiv Diagnosis And Its Distributions Among African Americans And Latinos: A Critical Literature Review, Alison M. Chopel, Meredith Minkler, Amani Nuru-Jeter, Megan Dunbar

Journal of Health Disparities Research and Practice

ABSTRACT

This critical literature review was conducted to identify both individual- and environmental-level social determinants of health using an ecological framework as a way to contextualize risk for, and distributions of, late HIV diagnosis among African Americans and Latinos in the United States.

Background: Late diagnosis, defined as a diagnosis of AIDS simultaneously with or within one year of an initial HIV diagnosis,¹ disproportionately affects African American and Latino communities;^2,3 disparities in this health problem thus represent a preventable inequity. Such disparities affect not only late diagnosed individuals but also population levels of HIV incidence, as transmission is …

Factors Associated With Colorectal Cancer Screening Among Younger African American Men: A Systematic Review, Charles R. Rogers, Patricia Goodson, Margaret Foster

Journal of Health Disparities Research and Practice

Of cancers affecting both men and women, colorectal cancer (CRC) is the second leading cancer killer among African Americans in the U.S. Compared to White men, African American men have incidence and mortality rates 25% and 50% higher from CRC. Despite the benefits of early detection and the availability of effective screening, most adults over age 50 have not undergone testing, and disparities in colorectal cancer screening (CRCS) persist. Owing to CRC’s high incidence and younger age at presentation among African American men, CRCS is warranted at age 45 rather than 50. However, the factors influencing young adult (i.e., age < 50) African American men’s intention to screen and/or their CRCS behaviors has not been systematically assessed. To assess whether the factors influencing young adult African American men’s screening intentions and behaviors are changeable through structured health education interventions, we conducted a systematic review, with the two-fold purpose of: (1) synthesizing studies examining African American men's knowledge, beliefs, and behaviors regarding CRCS; and (2) assessing these studies’ methodological quality. Utilizing Garrard’s Matrix Method, a total of 28 manuscripts met our inclusion/exclusion criteria: 20 studies followed a non-experimental research design, 4 comprised a quasi-experimental design, and 4, an experimental design. Studies were published between 2002 and 2012; the majority, between 2007 and 2011. The factors most frequently assessed were behaviors (79%), beliefs (68%), and knowledge (61%) of CRC and CRCS. Six factors associated with CRC and CRCS emerged: previous CRCS, CRC test preference, perceived benefits, perceived barriers, CRC/CRCS knowledge, and physician support/recommendation. Studies were assigned a methodological quality score (MQS – ranging from 0 to 21). The mean MQS of 10.9 indicated these studies were, overall, of medium quality and suffered from specific flaws. Alongside a call for more rigorous research, this review provides important suggestions for practice and culturally relevant interventions.

Experiences With The Streptococcus Mutans In Lakota Sioux (Smiles) Study: Risk Factors For Caries In American Indian Children 0-3 Years, David R. Drake, Deborah Dawson, Katherine Kramer, Amy Schumacher, John Warren, Teresa Marshall, Delores Starr, Kathy Phipps

Journal of Health Disparities Research and Practice

Severe Early Childhood Caries (S-ECC) is a terribly aggressive and devastating disease that is all too common in lower socio-economic children, but none more so that what is encountered in American Indian Tribes. Nationwide, approximately 27% of 2-5 year olds have decay while 62% percent of American Indian/Alaska Native children in the same age group have a history of decay (IHS 2010, NHANES 1999-2002). We have conducted a study of children from birth to 36 months of age on Pine Reservation to gain a better understanding of the variables that come into play in the development of this disease, from …

Hispanic Ethnicity Is Associated With Increased Hospital Charges After Radical Cystectomy In The United States, Mark D. Tyson, Erik P. Castle

Journal of Health Disparities Research and Practice

Objective: To examine the impact of race and ethnicity on financial charges associated with radical cystectomy (RC).

Data Sources/Study Setting: The Nationwide Inpatient Sample was used to identify patients who underwent RC for bladder cancer between 1998 and 2010.

Study Design: The primary outcome was total hospital charges adjusted for inflation. Multivariate analysis was performed using a generalized linear model on the logarithmically transformed outcome variable (total hospital charges) after adjusting for age, sex, race, Elixhauser comorbidities, surgical approach, year, primary payer, hospital and surgeon annual RC volume, hospital characteristics, and postoperative complications.

Principle findings: A total of 14,873 patients …

Assessment Of The Perceived Role And Function Of A Community Advisory Board In A Nih Center Of Excellence: Lessons Learned, Margaret L. Walsh, Desiree Rivers, Maria Pinzon, Nina Entrekin, Emily M. Hite, Julie A. Baldwin

Journal of Health Disparities Research and Practice

Background: The Community Advisory Board (CAB) was a vital component of the Center for Equal Health. The center addressed health disparities through community-based research and educational outreach initiatives. Objectives: To evaluate the perceived relationship of the CAB and Center, explore members’ perceptions of the CAB’s role, and elicit feedback on how to enhance the relationship between the Center and the CAB. Methods: Ten in-depth, semi-structured interviews were conducted. All interviews were transcribed verbatim and analyzed with a focus on predetermined codes. Results: Main themes focused on perception of CAB roles and need for utilization of board members; overall center challenges; …

Caregivers Of Underserved Minority Populations: Views And Opinions Of The Role Of Schools In Bmi Screening, Education And Communication, Lori Keough Phd, M.Ed, Fnp-Bc

Journal of Health Disparities Research and Practice

A pilot study exploring caregiver views of the role of schools in students’ health.

Abstract

To date, 20 states in theUnited Statesrequire school-based body mass index (BMI) screening for school-aged populations and for some the requirements include caregiver notification of the findings. Few studies have provided empirical data indicating whether or not caregivers accept or act on BMI communication from schools. Therefore, an exploratory pilot study was conducted in a culturally diverse urban school district to determine how a required (BMI) screening and notification were viewed by caregivers. Most caregivers reported that they felt schools did not have a role …

Implementation And Feasibility Of An Auricular Acupuncture Intervention For Smoking Cessation In A Residential Spiritual Recovery Program: A Pilot Study, Cynthia Johnson, Payam Sheikhattari, Lixing Lao, Yvonne Bronner, Fernando Wagner

Journal of Health Disparities Research and Practice

Abstract

This study examined the feasibility of recruiting of participants and retention to an auricular acupuncture intervention for smoking cessation at a residential spiritual recovery program for a chemically dependent population in the mid-Atlantic region. The association between beliefs about acupuncture and smoking cessation were also assessed. This was an intervention study guided by the principles of Community Based Participatory Research (CBPR).

The National Acupuncture Detoxification Association (NADA) protocol was used as part of the smoking cessation intervention (participants received auricular acupuncture for 40 minutes, 3 times per week for 1 month). Smoking cessation, adherence rate to the treatment plan, …

The Complexities Of Childhood Obesity: A Qualitative Study Among Mexican American Mothers, Erica T. Sosa, E. Lisako Mckyer, Buzz Pruitt, Patricia Goodson, Linda Castillo

Journal of Health Disparities Research and Practice

Introduction: Mothers play an important role in preventing childhood obesity; however, might differ in how they define healthy weight and the associated consequences. Due to the lack of research investigating how Mexican American mothers perceive childhood obesity, the purpose of this paper is to qualitatively assess Mexican-American mothers’ perceptions regarding childhood obesity, its causes and consequences.

Methods: Three focus groups, two in Spanish and one in English, were conducted with 23 mothers in Bryan, TX. Thematic analysis was performed by three researchers independently using sentences as the unit of meaning.

Findings: Mexican American mothers believed that a …

Obstetrician-Gynecologists’ Knowledge Of Health Disparities And Barriers Among American Indian/Alaska Native Women In Washington State, Katherine M. Jones, Greta B. Raglan, Sophia M. Lannon, Jay Schulkin

Journal of Health Disparities Research and Practice

Background: Health disparities between American Indian/Alaska Native (AI/AN) women and other races/ethnicities have long been noted. Obstetricians-Gynecologists (Ob-Gyn) play a significant role in well-woman care and are often the first and most frequent point of medical contact for women, particularly among minority and low-income women.

Objective: This study aimed to assess Ob-Gyns’ knowledge, beliefs, and practices related to health disparities among AI/AN women.

Method: A self-administered questionnaire, consisting of questions about knowledge, beliefs, and practices of health disparities among AI/AN women, was mailed to 722 members of The American College of Obstetricians and Gynecologists (ACOG) practicing in the state of …

Disparities In Hospital Services Utilization Among Patients With Mental Health Issues: A Statewide Example Examining Insurance Status And Race Factors From 1999-2010, Viann N. Nguyen-Feng, Hind A. Beydoun, Michael K. Mcshane, James D. Blando

Journal of Health Disparities Research and Practice

There exist many disconnects between the mental and general health care sectors. However, a goal of the Affordable Care Act (ACA) of 2010 is to change this by improving insurance access and the intersection of mental and general health care. As insurance status intersects with race, the present study examines how race, insurance status, and hospital mental health services utilization differ across groups within the state of New Jersey. The present study aims to determine trends in hospital mental health care utilization by insurance status and race from 1999 to 2010. The rate of self-pay for mental health disorders in …

Factors Influencing Hpv Vaccine Use Among Racially Diverse Female College Students, Timmerie F. Cohen, Jeffrey Legg

Journal of Health Disparities Research and Practice

Abstract

Objective. This study describes Human Papillomavirus (HPV) vaccination rates and possible factors influencing vaccination utilization rates in a diverse population of college women 18-26 years old.

Methods. The National College Health Assessment survey provided a large diverse sample size (N=67,762) in which to perform descriptive and binary logistic regression analysis. Demographic characteristics were analyzed as potential barriers to HPV vaccination. Additionally, lack of certain health behaviors were explored as potential barriers to HPV vaccination.

Results. In this study, White/non-Hispanic women had a higher HPV vaccination rate when compared to minority women. Binary regression analysis demonstrated that minority …

Modeling Bmi, Dietary Habits, And Physical Activity Among Ethnically Diverse Urban College Students, Hollie Jones, Nicholas Freudenberg, Lorraine Mongiello

Journal of Health Disparities Research and Practice

Objectives The objective of this research study was to examine the relationship between BMI, physical activity, dietary habits, and student demographic factors (age, ethnicity, income, immigration, and sex). Given the association between overweight and obesity and the inequitable burden of chronic health conditions among ethnic minority populations, a deeper understanding of the socioeconomic, gender, age, and racial/ethnic variation in BMI, physical activity, and dietary habits is needed. The shifting demographics of urban college populations make urban college campuses an important setting for addressing the lifetime health needs of ethnically diverse urban populations.

Methods In this cross-sectional non-experimental study, we used …

Addressing Disparities In Access To Information For Hispanic Families Of Children With Special Health Care Needs, Suzanne M. Bronheim, Sandra Soto, Bruno J. Anthony

Journal of Health Disparities Research and Practice

Objectives: Utilizing a diffusion of innovation (DOI) framework, the study seeks to increase access to information for Hispanic families of children with special health care needs (SHCN) by increasing their use of Family-to-family Centers (F2Fs) in their states. Methods: Focus groups were implemented of both English-speaking and Spanish-speaking Hispanic families in two states with a confirming Delphi procedure exploring factors within DOI framework related to using F2Fs and the nature of current family communication networks. Results: Families seeking information at key change points turn to formal sources, although Spanish-speaking families, noted that due to language barriers, they also turned to …

Personal, Family, And Peer Correlates Of General And Sport Physical Activity Among African American, Latino, And White Girls, Susan C. Duncan, Lisa A. Strycker, Nigel R. Chaumeton

Journal of Health Disparities Research and Practice

This study examined associations between personal, family, and peer variables on objectively measured physical activity (PA), and sports participation, of African American, Latino, and white girls. Specific variables included barriers efficacy, parent PA, parent support of PA, the home exercise environment, friends’ PA, and friends’ support of PA. The sample comprised 372 girls (mean age = 12.03 years; SD = 1.81; n = 128 African American, n = 120 Latino, and n = 124 white). Data were analyzed using multiple-sample structural equation models (by ethnicity), controlling for age, household income, body mass index, and physical development. Girls’ moderate to vigorous …

The Self-Reported Sexual Behaviors Of Single Older African Americans, Victoria Foster, Patricia C. Clark, Marcia M. Holstad

Journal of Health Disparities Research and Practice

Abstract

African Americans are disproportionally affected by HIV/AIDS, but little is known about the risky sexual behaviors of older African Americans. This cross-sectional, comparative study, investigated the self-reported sexual behaviors of sexually active older African Americans. The nonrandom sample (N = 78) included single African American men (59%) and women (41%), 50-74 years of age. Participants were recruited from various community sites, and data were collected with a standard sexual history questionnaire. Participants reported practicing risky behaviors such having unprotected oral, anal, and vaginal sex (96.5%), and having multiple sex partners (37.2%). There were several significant gender differences such …

The Feasibility Of Delivering A Home-Based Motivational Exercise Program To African-American Breast Cancer Survivors, Denise Spector, Claudio Battaglini

Journal of Health Disparities Research and Practice

Most African-American breast cancer survivors do not meet current exercise recommendations for cancer survivors, which include both aerobic and strength-training exercises. This pilot study tested the feasibility of delivering a home-based exercise intervention to African-American breast cancer survivors. Sedentary African-American breast cancer survivors were recruited for a 16-week motivational home-based progressive aerobic and strength-training exercise pilot study. Participants completed weekly exercise logs and received weekly phone calls. To assess feasibility, we evaluated recruitment, retention, and adherence rates, as well as participant acceptance and safety. 17 women enrolled; 13 completed the intervention (76%). Participants had moderately-high adherence (70%) to walking goals, …

Racial/Ethnic Disparities Related To Health Insurance Coverage, Access To Care And Ease In Health Care Services Among Children In 2012 Cchaps Data, Jacquelynn Meeks, Sweety Baidhya

Journal of Health Disparities Research and Practice

nObjective:The aim of this study was to examine racial/ethnic disparities in unmet medical care, dental care and prescription medications and ease of using heath care services.

Methods:This is a cross sectional study of households in a six-county service region in Texas (Tarrant, Johnson, Hood, Parker, Wise and Denton Counties). The participants included the parents/guardians of children aged 1-15 years. In 2012, a total of 8,439 parents completed the survey. In 2012, 4194 completed the version containing the health insurance type and unmet medical, prescription and dental health care and ease/difficulty in access to health care questions.The dependent variables …

Psychosocial Correlates Of Perceived Stress And Depressive Symptoms Among Help-Seeking Hispanic Smokers, Monica Webb Hooper Phd

Journal of Health Disparities Research and Practice

Objectives: Research has demonstrated robust associations between perceived stress, depressive symptoms, and cigarette smoking. The extent to which these findings from the general population generalize to Hispanic smokers is unknown. The present study examined (a) correlates of perceived stress and depressive symptoms among help-seeking Hispanic smokers and (b) whether maladaptive coping and social support were related to stress and depressive symptoms. Design: Hispanic smokers (N=123) enrolled in an RCT completed demographic and smoking history, perceived stress, depressive symptoms, perceived social support, and maladaptive coping measures. Results: Bivariate associations indicated that perceived stress was positively correlated with depressive symptoms …

Reducing Health Disparities Through The 2015 Mcat: A Bold Goal Requiring On-Going Assessment, Aliya G. Feroe, Stephen F. Loebs

Journal of Health Disparities Research and Practice

There is broad consensus that reduction in health care disparities is an important and multi-faceted challenge. One possible approach, among many others, starts with the attraction of women and men to the field of medicine who have a broad based education and who can demonstrate cultural understanding and sensitivity. In this context, the Medical College Admissions Test (MCAT) has been revised, effective in 2015, to include many additional questions concerning the psychological, social, and behavioral sciences. There are important assumptions fueling the revised Medical College Admissions Test (MCAT) and these will need to be tested. These assumptions range from influencing …

Chronic Physical Health Conditions Among Homeless, Nooshin Nikoo, Marjan Motamed, Mohammad Ali Nikoo, Verena Strehlau, Erika Neilson, Sahoo Saddicha, Michael Krausz

Journal of Health Disparities Research and Practice

ABSTRACT

Objective: Morbidity and mortality among homeless individuals is higher than the general population. This study aims to determine the prevalence of current self-reported, chronic physical health conditions in a large sample of homeless people with sub-samples from shelters and street in British Columbia, Canada. Methods: Cross-sectional survey applying modified version of the ‘National Survey of Homeless Assistance Providers and Clients (NSHAPC)’ questionnaire in multiple sites in Vancouver, Victoria and Prince George, British Columbia, Canada. Sample: Five hundred homeless individuals were surveyed between May and September of 2009. A person was defined as homeless if he/she had a …

Evaluation Of The Nci’S Community Cancer Centers’ Program (Ncccp): Impact On Disparities In Quality Of Cancer Care, Michael T. Halpern, Pamela Spain, Debra J. Holden, Andrew K. Stewart, Erica J. Mcnamara, Greer Gay, Steven B. Clauser, Irene Prabhu Das

Journal of Health Disparities Research and Practice

This study examined the effects of the NCCCP pilot on breast or colon cancer quality of care for patients from underserved populations and those treated at disparities-focused hospitals (NCCCP sites having fewer oncology resources or in communities with greater proportions of underserved populations). Data on five quality of care measures were collected using the Commission on Cancer’s Rapid Quality Reporting System. Following NCCCP initiation, we observed improvements in all five quality of care measures. There were similar quality of care improvements for Black vs. White patients, privately insured vs. Medicaid or uninsured patients, and men vs. women. Patients treated at …