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A Roundtable On Cross-Sector Collaboration And Resource Alignment For Health Equity: Meeting Summary, Onyemaechi Nweke 2017 US Department of Health and Human Services

A Roundtable On Cross-Sector Collaboration And Resource Alignment For Health Equity: Meeting Summary, Onyemaechi Nweke

Journal of Health Disparities Research and Practice

Cross-sector collaboration is a highly recommended strategy to eliminate health inequities nationally and globally. In the federal sector, it is evolving into an important approach for solving complex social problems, as evidenced by its steady proliferation the past few decades. Despite the increased adoption of cross-sector collaboration, it is still not a default strategy or preeminent option for managing complex social problems. In September 2015, the Federal Interagency Health Equity Team (FIHET) hosted a Roundtable event to discuss opportunities and strategies to foster widespread adoption of cross-sector collaboration and resource alignment. The Roundtable featured several expert panelists and participants from ...


An Assessment Of Funding And Other Capacity Needs For Health Equity Programming Within State-Level Chronic Disease Programs, Tiffany Pertillar, Ann Pobutsky, PhD, Gail Brandt, EdD, MPH, Marisa New, OTR, MPH, JamieLou Delavan, BA, Robyn Taylor, MBA, Amishi Shah, MPA, MA, Folasaya Adunola, DDS, MPH, Onyemaechi Nweke 2017 National Association of Chronic Disease Directors

An Assessment Of Funding And Other Capacity Needs For Health Equity Programming Within State-Level Chronic Disease Programs, Tiffany Pertillar, Ann Pobutsky, Phd, Gail Brandt, Edd, Mph, Marisa New, Otr, Mph, Jamielou Delavan, Ba, Robyn Taylor, Mba, Amishi Shah, Mpa, Ma, Folasaya Adunola, Dds, Mph, Onyemaechi Nweke

Journal of Health Disparities Research and Practice

Background: Chronic diseases are an important contributor to morbidity and mortality among racial/ethnic minority, low-income, and other under-resourced populations. Given that state health departments (and their chronic disease programs) play a significant role in providing population and preventive health services, their capacity to promote health equity is an important consideration in national efforts to address chronic diseases. The purpose of this study was to examine capacity needs of state chronic disease programs with respect to promoting health equity.

Methods: In 2015, the National Association of Chronic Disease Directors (NACDD) conducted a survey of its members that work within a ...


Achieving Health Equity For Indian Country, Jamie Ishcomer 2017 National Indian Health Board

Achieving Health Equity For Indian Country, Jamie Ishcomer

Journal of Health Disparities Research and Practice

The essence of health equity is giving resources where they are needed most. American Indians and Alaska Natives (AI/AN) continue to have the worst health outcomes, live in some of the most desperate of conditions, and lack access to even basic amenities that many other Americans could not survive without. Although Tribes have been plagued with social, economic and political injustice for centuries, there is an opportunity to put a stop to the systematic oppression and build up the first peoples of this country. A partnership between the National Indian Health Board (NIHB) and the National Partnership for Action ...


Rhode Island’S Health Equity Zones: Addressing Local Problems With Local Solutions, Nicole Alexander-Scott, MD, MPH, Ana P. Novais, MA, Carol Hall-Walker, MPA, Angela B. Ankoma, MPH, MSW, John P. Fulton, PhD 2017 Rhode Island Department of Health

Rhode Island’S Health Equity Zones: Addressing Local Problems With Local Solutions, Nicole Alexander-Scott, Md, Mph, Ana P. Novais, Ma, Carol Hall-Walker, Mpa, Angela B. Ankoma, Mph, Msw, John P. Fulton, Phd

Journal of Health Disparities Research and Practice

The Rhode Island Department of Health (RIDOH) describes the strategies and infrastructure it has developed to fund its placed-based initiatives to address the social determinants of health to eliminate health disparities. Using a data driven and community-led approach, RIDOH funded 10 local collaboratives, each with its own, geographically-defined “Health Equity Zone,” or “HEZ,” and, to support the collaboratives, created a new “Health Equity Institute,” a “HEZ Team” of 9 seasoned project managers, and direct lines of communications between these assets and the Office of the Director of Health.


Implementation Of The National Partnership For Action To End Health Disparities: A Three-Year Retrospective, Oscar Espinosa, Onyemaechi Nweke 2017 Community Science

Implementation Of The National Partnership For Action To End Health Disparities: A Three-Year Retrospective, Oscar Espinosa, Onyemaechi Nweke

Journal of Health Disparities Research and Practice

In April 2011, the U.S. Department of Health and Human Services’ (HHS) Office of Minority Health (OMH) launched the National Partnership for Action to End Health Disparities (NPA) to increase the effectiveness of efforts to eliminate health disparities by coordinating partners, leaders, and stakeholders committed to action. At its core, the NPA is an experiment in collaboration that relies heavily on those on the front line who are actively engaged in minority health work at multiple levels. It gives them the responsibility of identifying and helping to define core actions, new approaches, and new partnerships that ultimately will help ...


The Guide To Community Preventive Services Review Of Interventions To Promote Health Equity In The United States, Robert Hahn, Jonathan E. Fielding, M.D., M.P.H., M.A., M.B.A, Robert L. Johnson, M.D., Carles Muntaner, M.D., Ph.D., M.H.S., Benedict I. Truman, M.D., M.P.H., Tracy Orleans 2017 U.S. Centers for Disease Control and Prevention

The Guide To Community Preventive Services Review Of Interventions To Promote Health Equity In The United States, Robert Hahn, Jonathan E. Fielding, M.D., M.P.H., M.A., M.B.A, Robert L. Johnson, M.D., Carles Muntaner, M.D., Ph.D., M.H.S., Benedict I. Truman, M.D., M.P.H., Tracy Orleans

Journal of Health Disparities Research and Practice

The optimal approach to eliminating health inequities is through evidence-based interventions. In 2009, the non-federal Community Preventive Services Task Force launched a series of systematic reviews of interventions to promote health equity. Topics to be considered include education, employment, housing, and transportation. Thus far, reviews have focused on educational interventions: center-based early childhood education, full-day kindergarten programs, out-of-school time academic programs, high school completion programs, and school-based health centers. These reviews demonstrate the benefits of diverse educational interventions in advancing health equity. Here, we summarize the strategy of Community Guide health equity reviews, first findings and challenges.


Improving Access And Utilization Of Data To Support Research And Programs Intended To Eliminate Disparities And Promote Health Equity, Rosaly Correa-de-Araujo 2017 National Institute on Aging, National Institutes of Health

Improving Access And Utilization Of Data To Support Research And Programs Intended To Eliminate Disparities And Promote Health Equity, Rosaly Correa-De-Araujo

Journal of Health Disparities Research and Practice

Numerous Federal initiatives are addressing health and health care disparities. The ultimate goal is to achieve “a nation free of disparities in health and health care.” Social determinants of health remain mostly responsible for health/health care disparities among population groups within and between countries. In the United States, there is little evidence that disparities associated with such determinants are decreasing, with only 10% of those associated with race/ethnicity and income having demonstrated improvement in recent years. A variety of data sources are available from the Federal and private sectors to support research on disparities, but no single national ...


Translational Research: Ethical Considerations, Yiqing Dong 2017 University of Puget Sound

Translational Research: Ethical Considerations, Yiqing Dong

Sound Decisions: An Undergraduate Bioethics Journal

Translational research (TR) is a new categorization for the efforts of biomedical research and emphasizes efficiency in achieving population health improvements through the application of basic science knowledge in clinical practice. It will be argued that the current emphasis on speed and collaboration with industry established by national policies provides challenges to maintaining the integrity of scientific research. There is no agreed upon definition of TR and the current standard of judging the success of TR focuses on product production. I propose that the principles of beneficence and responsive justice should be used to inform the values of TR and ...


Caste Matters: Perceived Discrimination Among Women In Rural India, Apurv Soni, Jasmine A. Khubchandani, Nisha Fahey, Nitin Raithatha, Anusha Prabhakaran, Nancy Byatt, Tiffany A. Moore Simas, Ajay Phatak, Milagros C. Rosal, Somashekhar Nimbalkar, Jeroan J. Allison 2017 University of Massachusetts Medical School

Caste Matters: Perceived Discrimination Among Women In Rural India, Apurv Soni, Jasmine A. Khubchandani, Nisha Fahey, Nitin Raithatha, Anusha Prabhakaran, Nancy Byatt, Tiffany A. Moore Simas, Ajay Phatak, Milagros C. Rosal, Somashekhar Nimbalkar, Jeroan J. Allison

Nancy Byatt

Purpose: To examine the relationship of caste and class with perceived discrimination among pregnant women from rural western India.

Methods: A cross-sectional survey was administered to 170 pregnant women in rural Gujarat, India, who were enrolled in a longitudinal cohort study. Everyday Discrimination Scale and Experiences of Discrimination questionnaires were used to assess perceived discrimination and response to discrimination. Based on self-reported caste, women were classified to three categories with increasing historical disadvantage: General, Other Backward Castes (OBC), and Scheduled Caste or Tribes (SC/ST). Socioeconomic class was determined using standardized

Kuppuswamy scale. Regression models for count and binomial data ...


Direct-To-Patient Pro Collection To Support Quality Improvement In Tjr, Hua Zheng, Celeste A. Lemay, Wenyun Yang, Patricia D. Franklin 2017 University of Massachusetts Medical School

Direct-To-Patient Pro Collection To Support Quality Improvement In Tjr, Hua Zheng, Celeste A. Lemay, Wenyun Yang, Patricia D. Franklin

Celeste A. Lemay

Introduction: Patient-reported outcomes (PROs) are widely used in orthopedic clinical research to evaluate quality of care. However, it is difficult to capture complete post-operative PRO data through surgeon office visits. The UK and Sweden collect post-TJR PRO measures directly from patients in their homes. We compared two US post-operative PRO collection processes- PROs in clinic at scheduled office visits and direct-to-patient collection, to evaluate timing and completeness of both approaches.

Methods: At a large TJR center that has collected PROs at office visits routinely for years, post-TJR patients complete a PRO survey on a computer at follow-up clinic visits. In ...


Recruiting Low Income Post-Partum Women Into A Weight Loss Trial: In-Person Versus Facebook Delivery, Valerie J. Silfee, Andrea Lopez-Cepero, Stephenie C. Lemon, Milagros C. Rosal 2017 University of Massachusetts Medical School

Recruiting Low Income Post-Partum Women Into A Weight Loss Trial: In-Person Versus Facebook Delivery, Valerie J. Silfee, Andrea Lopez-Cepero, Stephenie C. Lemon, Milagros C. Rosal

Milagros C. Rosal

Several studies, such as the Diabetes Prevention Program (DPP), have provided foundational evidence for the effect of lifestyle modification interventions on diabetes prevention and weight loss. However, translating these programs to the real-world has proven difficult. There remains a need to increase the feasibility and reach of translational weight loss interventions.

PURPOSE: To compare the recruitment rates of overweight low income postpartum women into a DPP-adapted behavioral weight loss program delivered in-person versus delivered via Facebook.

METHODS: We compared two 8-week pilot behavioral weight loss trials; one delivered via weekly in-person group sessions and the other delivered entirely via Facebook ...


Developing A Community-Based Screening And Referral Mechanism For Atrial Fibrillation In Low Resource Settings: “Smartphone Monitoring For Atrial Fibrillation In Real-Time – India (Smart-India)”, Apurv Soni, Nisha Fahey, Harshil Patel, Kandarp Talati, Anna Handorf, John A. Bostrom, Shyamsundar Raihatha, Ravi Shah, Sunil Karna, Robert J. Goldberg, Jeroan J. Allison, Ki Chon, Somashekhar M. Nimbalkar, David D. McManus 2017 University of Massachusetts Medical School

Developing A Community-Based Screening And Referral Mechanism For Atrial Fibrillation In Low Resource Settings: “Smartphone Monitoring For Atrial Fibrillation In Real-Time – India (Smart-India)”, Apurv Soni, Nisha Fahey, Harshil Patel, Kandarp Talati, Anna Handorf, John A. Bostrom, Shyamsundar Raihatha, Ravi Shah, Sunil Karna, Robert J. Goldberg, Jeroan J. Allison, Ki Chon, Somashekhar M. Nimbalkar, David D. Mcmanus

Jeroan J. Allison

BACKGROUND: Atrial fibrillation (AF), the world’s most common arrhythmia, often goes undetected and untreated in low-resource communities, including India. Moreover, AF is an important risk factor for stroke, which plagues an estimated 1.6 million Indians annually. As such, early detection of AF and management of high-risk patients is critically important to decrease stroke burden in individuals with AF.

OBJECTIVE: The objectives of this study are to evaluate the age- and sex-stratified epidemiology of AF in Anand District, Gujarat India; characterize the profile of individuals who are diagnosed with AF; and determine the performance of two mobile technologies for ...


Caste Matters: Perceived Discrimination Among Women In Rural India, Apurv Soni, Jasmine A. Khubchandani, Nisha Fahey, Nitin Raithatha, Anusha Prabhakaran, Nancy Byatt, Tiffany A. Moore Simas, Ajay Phatak, Milagros C. Rosal, Somashekhar Nimbalkar, Jeroan J. Allison 2017 University of Massachusetts Medical School

Caste Matters: Perceived Discrimination Among Women In Rural India, Apurv Soni, Jasmine A. Khubchandani, Nisha Fahey, Nitin Raithatha, Anusha Prabhakaran, Nancy Byatt, Tiffany A. Moore Simas, Ajay Phatak, Milagros C. Rosal, Somashekhar Nimbalkar, Jeroan J. Allison

Jeroan J. Allison

Purpose: To examine the relationship of caste and class with perceived discrimination among pregnant women from rural western India. Methods: A cross-sectional survey was administered to 170 pregnant women in rural Gujarat, India, who were enrolled in a longitudinal cohort study. Everyday Discrimination Scale and Experiences of Discrimination questionnaires were used to assess perceived discrimination and response to discrimination. Based on self-reported caste, women were classified to three categories with increasing historical disadvantage: General, Other Backward Castes (OBC), and Scheduled Caste or Tribes (SC/ST). Socioeconomic class was determined using standardized Kuppuswamy scale. Regression models for count and binomial data ...


Exploring The Contributions Of Local Health Departments In Land Use And Transportation Policy: Implications For Cross-Sector Collaboration, Meera Sreedhara, Karin V. Goins, Semra Aytur, Katie Heinrich, Jay Maddock, Stephenie C. Lemon 2017 University of Massachusetts Medical School

Exploring The Contributions Of Local Health Departments In Land Use And Transportation Policy: Implications For Cross-Sector Collaboration, Meera Sreedhara, Karin V. Goins, Semra Aytur, Katie Heinrich, Jay Maddock, Stephenie C. Lemon

Stephenie C. Lemon

Introduction: Transportation and land use policies can impact physical activity. Local health departments (LHDs) are encouraged to participate in land use and transportation policy processes, which are outside their traditional expertise. Cross-sector collaborations are needed, yet stakeholders’ perceptions of LHD involvement are not well-understood. This paper explores (1) the perceived value of LHD participation in transportation and land use decision-making and (2) potential contributions of LHDs to these processes among relevant stakeholders.

Methods: Qualitative data were analysed from 49 semi-structured interviews conducted in 2015 and 2016. Participants were professionals representing land use planning (n=13), transportation/public works (n=11 ...


Recruiting Low Income Post-Partum Women Into A Weight Loss Trial: In-Person Versus Facebook Delivery, Valerie J. Silfee, Andrea Lopez-Cepero, Stephenie C. Lemon, Milagros C. Rosal 2017 University of Massachusetts Medical School

Recruiting Low Income Post-Partum Women Into A Weight Loss Trial: In-Person Versus Facebook Delivery, Valerie J. Silfee, Andrea Lopez-Cepero, Stephenie C. Lemon, Milagros C. Rosal

Stephenie C. Lemon

Several studies, such as the Diabetes Prevention Program (DPP), have provided foundational evidence for the effect of lifestyle modification interventions on diabetes prevention and weight loss. However, translating these programs to the real-world has proven difficult. There remains a need to increase the feasibility and reach of translational weight loss interventions.

PURPOSE: To compare the recruitment rates of overweight low income postpartum women into a DPP-adapted behavioral weight loss program delivered in-person versus delivered via Facebook.

METHODS: We compared two 8-week pilot behavioral weight loss trials; one delivered via weekly in-person group sessions and the other delivered entirely via Facebook ...


“Can’T You Just Say?” – Contrasting Communication Preferences Between Surrogate Decision-Makers And Physicians During Outcome Prognostication In Critically-Ill Traumatic Brain Injury Patients, Thomas Quinn, Jesse Moskowitz, Muhammad Khan, Lori Shutter, Robert J. Goldberg, Nananda Col, Kathleen M. Mazor, Susanne Muehlschlegel 2017 University of Massachusetts Medical School

“Can’T You Just Say?” – Contrasting Communication Preferences Between Surrogate Decision-Makers And Physicians During Outcome Prognostication In Critically-Ill Traumatic Brain Injury Patients, Thomas Quinn, Jesse Moskowitz, Muhammad Khan, Lori Shutter, Robert J. Goldberg, Nananda Col, Kathleen M. Mazor, Susanne Muehlschlegel

Kathleen M. Mazor

Objective: Surrogate decision-makers (“surrogates”) and physicians of incapacitated patients have different views of prognosis and how it should be communicated, but this has not been investigated in neurocritically-ill patients. We examined communication preferences in surrogates and physician practices during the outcome prognostication for critically-ill traumatic brain injury (ciTBI) patients in neuroICUs.

Design: Qualitative study using in-person semi-structured interviews with surrogates of ciTBI patients and physicians with expertise in TBI.

Setting: Two neuroICUs at two level-1 trauma centers (surrogates); seven academic U.S. medical centers (physicians).

Subjects: Sixteen surrogates for 15 ciTBI patients and 20 attending physicians from neurocritical care, neurosurgery ...


Feasibility, Safety And Acceptability Of Soy-Based Diet For Pregnant Women: Preliminary Results From A Pilot Randomized Controlled Trial, Ling Shi, Vidya Iyer, Errol Norwitz, Tiffany A. Moore Simas, Nirupa R. Matthan, Alice H. Lichtenstein, Laura L. Hayman 2017 University of Massachusetts Boston

Feasibility, Safety And Acceptability Of Soy-Based Diet For Pregnant Women: Preliminary Results From A Pilot Randomized Controlled Trial, Ling Shi, Vidya Iyer, Errol Norwitz, Tiffany A. Moore Simas, Nirupa R. Matthan, Alice H. Lichtenstein, Laura L. Hayman

Tiffany A. Moore Simas

Background: Previous evidence suggests that soy containing foods may have beneficial effects on lipid and glycemic metabolism. Pregnancy is associated with a progressive deterioration in glucose and lipid metabolism, partially attributable to elevated estrogen concentrations. Little is known about the effects of soy intake on cardiometabolic risk factors in pregnant women. Methods: A pilot RCT was conducted in 30 pregnant women who were randomized to receive counseling to consume a high-soy or low-soy foods containing diet. Assessments (physical measurements, food frequency questionnaires, fasting blood samples) were conducted at 14 and 28 weeks of pregnancy, and 6 weeks’ postpartum. Monthly follow-up ...


Developing A Community-Based Screening And Referral Mechanism For Atrial Fibrillation In Low Resource Settings: “Smartphone Monitoring For Atrial Fibrillation In Real-Time – India (Smart-India)”, Apurv Soni, Nisha Fahey, Harshil Patel, Kandarp Talati, Anna Handorf, John A. Bostrom, Shyamsundar Raihatha, Ravi Shah, Sunil Karna, Robert J. Goldberg, Jeroan J. Allison, Ki Chon, Somashekhar M. Nimbalkar, David D. McManus 2017 University of Massachusetts Medical School

Developing A Community-Based Screening And Referral Mechanism For Atrial Fibrillation In Low Resource Settings: “Smartphone Monitoring For Atrial Fibrillation In Real-Time – India (Smart-India)”, Apurv Soni, Nisha Fahey, Harshil Patel, Kandarp Talati, Anna Handorf, John A. Bostrom, Shyamsundar Raihatha, Ravi Shah, Sunil Karna, Robert J. Goldberg, Jeroan J. Allison, Ki Chon, Somashekhar M. Nimbalkar, David D. Mcmanus

David D. McManus

BACKGROUND: Atrial fibrillation (AF), the world’s most common arrhythmia, often goes undetected and untreated in low-resource communities, including India. Moreover, AF is an important risk factor for stroke, which plagues an estimated 1.6 million Indians annually. As such, early detection of AF and management of high-risk patients is critically important to decrease stroke burden in individuals with AF.

OBJECTIVE: The objectives of this study are to evaluate the age- and sex-stratified epidemiology of AF in Anand District, Gujarat India; characterize the profile of individuals who are diagnosed with AF; and determine the performance of two mobile technologies for ...


Transcriptional Regulation Of Cardiac Remodeling In A Porcine Model With Validation In Human Subjects, Aditya Vaze, David D. McManus, Kevin Donahue 2017 University of Massachusetts Medical School

Transcriptional Regulation Of Cardiac Remodeling In A Porcine Model With Validation In Human Subjects, Aditya Vaze, David D. Mcmanus, Kevin Donahue

David D. McManus

Introduction: The majority of new atrial fibrillation (AF) cases occur in elderly patients with cardiac remodeling (CR) in the setting of structural heart disease and heart failure (HF). We leveraged a unique animal model to identify cardiac microRNAs (miRNAs) and gene regulatory mechanisms that drive this process. Methods: We prospectively quantified atrial expression of 48 miRNAs by high-throughput qRT-PCR in 15 pigs with right-atrial pacing-induced heart disease (5 pigs with AF/severe HF, 5 pigs with AF/mild HF, and 5 control pigs) as well as in 21 patients (11 with AF and CR and 10 controls) undergoing cardiac surgery ...


Accuracy And Coverage Of Using The Assigned International Classification Of Diseases, 9th And 10th Revision, Clinical Modification Codes For Detecting Bleeding Events In Electronic Health Record, Victoria J. Wang, David D. McManus, Hong Yu 2017 University of Massachusetts Medical School

Accuracy And Coverage Of Using The Assigned International Classification Of Diseases, 9th And 10th Revision, Clinical Modification Codes For Detecting Bleeding Events In Electronic Health Record, Victoria J. Wang, David D. Mcmanus, Hong Yu

David D. McManus

Background: Hemorrhages are common events that confer significant risk for in-hospital and post-discharge morbidity and mortality among cardiovascular disease (CVD) patients treated with anticoagulation. International Classification of Diseases, 9th and 10th Revision, Clinical Modification (ICD-9-CM, ICD-10-CM) codes have been widely used in CVD research and managements. Objective: To determine the accuracy and coverage of assigned ICD-CM codes for reporting bleeding events. Methods: From the University of Massachusetts Medical School electronic health record (EHR) database we identified 21k patients on anticoagulation with high bleeding risks based on their ICD-9-CM or ICD-10-CM codes. Through manual chart review, we selected one unstructured note ...


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