Medicine and Health Sciences Commons^™

Why Spiritual Leadership Matters In A New Physical Therapist Education Program, Ondrell S. Moore

Journal of Interprofessional Practice and Collaboration

Abstract

Physical therapists (PTs) function with a set of core values established to guide these rehabilitation specialists in providing person-centered care to diverse populations. Spiritual leadership aligns with the core values for the physical therapist. As community leaders and advocates, PTs are positioned to address health disparities that disproportionately affect rural communities and racial and ethnic minority groups. Physical therapist education programs that train student physical therapists to provide equitable care across cultures should reflect the diversity espoused by the American Physical Therapy Association (APTA). This article examines the impact of leadership in building a culture of belongingness and discusses …

Documenting & Describing Experiences Of Marginalized Gender Identities In Healthcare, Laura Stepnowski

Gettysburg Social Sciences Review

Despite its importance to quality and length of life, health varies widely among the U.S. population depending on various sociodemographic factors, such as age, race, gender, and income. This research focuses on the perception of treatment for those with marginalized gender identities. There is a long history of discrepancies in healthcare, but no time such as the present seems to be filled with such a nuanced perspective of quality of treatment for those with marginalized gender identities. This became evident through the focus groups conducted for this study. Findings show that participants used more collaborative language when discussing their positive …

Prevalence And Correlates Of Invitation To Participate In Clinical Trials Among Us Adults, Aurora Occa, Allison Leip, Allison S. Merritt, Jerod L. Stapleton

Communication Faculty Publications

Clinical trials are essential to modern medicine, but several barriers, including poor communication, hamper their successful completion. We examined the prevalence and correlates of invitation to participate in clinical trials among a nationally-representative sample of US adults using survey responses from the 2020 HINTS (Cycle 5). Analyses were conducted in 2021.

Overall, 9% of respondents reported being invited to a clinical trial, a prevalence that is nearly half of previously reported rates in convenience samples recruited from health care settings. Compared to non-Hispanic Whites, Black respondents reported the higher prevalence of invitation (16.0%) whereas Asian respondents reported the lowest (2%). …

A Lung Cancer Screening Personalized Decision-Aid Improves Knowledge And Reduces Decisional Conflict Among A Diverse Population Of Smokers At An Urban Academic Medical Center, Madeline Kaufman, Nilan Schnure, Andrea Nicholson, Frank Leone, Carmen Guerra

Journal of Health Disparities Research and Practice

Introduction: Few lung cancer screening decision aids have been tested in diverse populations. The study objective was to determine whether the online decision aid www.shouldiscreen.com impacts knowledge of and decisional conflict around lung cancer screening in a diverse population.

Methods: Eligible patients had significant smoking histories, were at increased risk for lung cancer (ages 45-80, >20 pack-years, smoking within last 15 years) and had no history of prior lung cancer or screening. Data was collected and analyzed in 2017.

Results: 40 patients were enrolled: 80% were female, 62.5% black, 33% white, and 48% had a high school …

Bilingual And Bicultural Research Teams: Unpacking The Complexities., Maya I I. Ragavan, John Cowden

Manuscripts, Articles, Book Chapters and Other Papers

Researchers often describe use of "bilingual/bicultural" research teams, especially for research being conducted with marginalized communities. In this perspectives article, we argue that while increasing the diversity of research teams is imperative, using the term "bilingual/bicultural" without further explanation is problematic. We first review the nuances of the terms bilingual and bicultural individually. Next, we describe how the terms bilingual and bicultural cannot be conflated. Finally, we provide recommendations for researchers, journals, and funding agencies.

Assessing Capacity To Engage In Healthcare To Improve The Patient Experience Through Health Information Technology, Cynthia J. Sieck, Daniel M. Walker, Megan Gregory, Naleef Fareed, Jennifer L. Hefner

Patient Experience Journal

Patient engagement is viewed as a means to improve patient care, increase population health, and decrease health care costs. Efforts to improve engagement are prevalent across healthcare, particularly through health information technology (HIT) tools such as patient portals. However, we know that not all patients have the same ability to engage, leading to potential disparities. We present the Engagement Capacity Framework and suggest that examining capacity for engagement would improve our ability to address currently unmeasured factors that facilitate engagement. The objective was to examine factors that influence an individual’s capacity for engagement through HIT. We administered a paper survey …

Racial/Ethnic Disparities In Diabetes Care And Outcomes: A Mixed Methods Study, Yhenneko J. Taylor, Marion E. Davis, Rohan Mahabaleshwarkar, Melanie D. Spencer

Journal of Health Disparities Research and Practice

Limited research has examined racial/ethnic differences in diabetes care and outcomes among primary care patients. This study examined racial/ethnic differences in diabetes care and outcomes among an ambulatory patient population and explored patient perceptions of the patient-provider relationship to inform strategies to improve care delivery. Using data from 62,149 adults with diabetes who received care within Atrium Health in 2013, regression models assessed associations between race/ethnicity and the following outcomes: glycated hemoglobin (HbA1c) tests, low density lipoprotein (LDL) and blood pressure (BP) screening, foot and eye exams, and HbA1c, LDL, and BP control. Eleven patients with diabetes and uncontrolled hypertension …

Each Medium Tells A Different Story: The Effect Of Message Channel On Narrative Persuasion, Nathan Walter, Sheila T. Murphy, Lauren B. Frank, Lourdes Baezconde-Garbanati

Communication Faculty Publications and Presentations

Limited attention has been given to the medium of story presentation in this process of narrative persuasion. The present study (N = 243) fills this gap by directly comparing narrative involvement across print and audiovisual versions of the same cervical cancer-related story. The mediation analysis revealed that exposure to an audiovisual narrative was associated with higher levels of cognitive and emotional involvement than exposure to the exact same narrative in its printed form. Yet the higher levels of transportation in the audiovisual condition came at a price of enhancing psychological reactance, eliminating the relative advantage of the film narrative.

Child-Mediated Health Communication: A Conceptual Framework For Increasing Stroke Literacy In Hard To Reach Populations, Olajide Williams, Ellyn Leighton-Herrmann, Mindy F. Hecht, Alexandra Desorbo, William Gerin, Monique Hedmann, Rachel Shelton, Benjamin Tolchin, James Noble

Journal of Health Disparities Research and Practice

Effectively engaging economically-disadvantaged ethnic minority communities for promoting health has proved to be challenging for a variety of reasons, including factors related to healthcare access, literacy, inadequate or ineffective cultural appropriateness of materials, and the relatively low priority for health due to competing demands related to economic hardship. We have developed a framework of Child-Mediated Health Communication (CMHC), which focuses on children as channels for carrying out health promotion interventions to parents and other caregivers. CMHC is an innovative, alternative strategy for engaging this underserved population, where traditional methods of health promotion have not been successful. We discuss the theoretical …

Development And Implementation Of A Culturally Tailored, Community-Based Intervention To Raise Awareness Of Brain Health Among African Americans, Mary Ann K. Hall, Ashani Johnson-Turbes, Felicia T. Fuller, Petra Niles, Shileah Cantey-Mcdonald

Journal of Health Disparities Research and Practice

African Americans bear a disproportionate burden of age-related cognitive impairment in the United States compared to Whites or Hispanics. African Americans experience greater prevalence, higher risk, and lower rates of treatment and diagnosis for dementia. In response to these health disparities the Alzheimer’s Association developed and implemented the Healthy Brain Initiative (HBI) demonstration project, the first community-level intervention to help reduce health disparities related to cognitive impairment among African Americans. The HBI promotes awareness of brain health, understanding of the heart-brain connection, and seeks to increase African American baby boomers engagement in health-protective behaviors to promote brain and overall health. …

Distributed Cognition In Cancer Treatment Decision Making: An Application Of The Decide Decision-Making Styles Typology, Janice L. Krieger, Jessica L. Krok-Schoen, Phokeng M. Dailey, Angela L. Palmer-Wackerly, Nancy Schoenberg, Electra D. Paskett, Mark Dignan

Department of Communication Studies: Faculty Publications

Distributed cognition occurs when cognitive and affective schemas are shared between two or more people during interpersonal discussion. Although extant research focuses on distributed cognition in decision making between health care providers and patients, studies show that caregivers are also highly influential in the treatment decisions of patients. However, there are little empirical data describing how and when families exert influence. The current article addresses this gap by examining decisional support in the context of cancer randomized clinical trial (RCT) decision making. Data are drawn from in-depth interviews with rural, Appalachian cancer patients (N = 46). Analysis of transcript …

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; …

Understanding Access To Health Information: The Role And Measurement Of Social Location, Megan S. Kelley

Theses & Dissertations

The purpose of this research is to explore how application of social location theory may improve data collection on health information access in order to better inform and improve the effectiveness of health communication and messaging. This dissertation proposes a framework to understand how people obtain health information based on the idea of social location, Ritzer and Bell’s (1981) levels of social reality, and Dahlberg & Krug’s (2002) social ecological model. This research addressed the extent to which three studies of health information access support the use of such a framework, and if so, how its application could improve our …

Comprehension Of Randomization And Uncertainty In Cancer Clinical Trials Decision Making Among Rural, Appalachian Patients, Janice L. Krieger, Angela L. Palmer-Wackerly, Phokeng M. Dailey, Jessica L. Krok-Schoen, Nancy E. Schoenberg, Electra D. Paskett

Department of Communication Studies: Faculty Publications

Comprehension of randomization is a vital, but understudied, component of informed consent to participate incancer randomized clinical trials(RCTs). Thisstudy examines patient comprehension of the randomization process as well as sources of ongoing uncertainty that may inhibit a patient’s ability to provide informed consent to participate in RCTs. Cancer patients living in rural Appalachia who were offeredanopportunitytoparticipateinacancertreatmentRCT completed in-depth interviews and a brief survey. No systematic differences in randomization comprehension between patients who consented and those who declined participation in a cancer RCT were detected. Comprehension is conceptually distinct from uncertainty, with patients who had both high and low comprehension experiencing …

Community Engagement As A Process And An Outcome Of Developing Culturally Grounded Health Communication Interventions: An Example From The Decide Project, Angela L. Palmer-Wackerly, Jessica Krok, Phokeng M. Dailey, Linda Kight, Janice L. Krieger

Department of Communication Studies: Faculty Publications

Community engagement is a process often used in developing effective health communication interventions, especially in traditionally underserved cultural contexts. While the potentially positive outcomes of community engagement are well established, the communication processes that result in engagement with cultural groups are less apparent. The focus on the outcomes of engagement at the expense of describing how engagement occurs makes it difficult for methods to be improved upon and replicated by future studies. The purpose of the current manuscript is to illustrate the process of achieving community engagement through the development of a culturally grounded health communication intervention. We offer practical …

Variance In Patient Access To Support Persons By Race/Ethnicity And Language Preference: An Analysis Of Patient Survey Data, Andrew J. Jager, Matthew K. Wynia

Journal of Health Disparities Research and Practice

Regulatory and accreditation organizations have advocated open visitation policies and allowance of support persons of patients’ choosing, but it is unknown if support is allowed equitably. Data from hospitalized patients were analyzed to determine access to support persons, stratified by patient-reported race/ethnicity, language, sex, age, and education. A multivariate regression model was constructed using race and language, controlling for site and patient sex, education and age. Additionally, sites’ policies explicitly allowing support persons were correlated to reports of allowance of support persons. Among 1,196 respondents, 17% reported not being allowed a support person or being unsure. African American patients had …

African Americans And Hospice: A Culture-Centered Exploration Of Disparities In End-Of-Life Care, Patrick Dillon

USF Tampa Graduate Theses and Dissertations

As the United States' population ages and grows more diverse, scholars and practitioners have grown increasingly concerned about persistent disparities in the cost and quality of end-of-life health care, particularly with regard to African Americans. Although a variety of factors may influence these disparities, most scholars agree that the underutilization of hospice care by this population is an important contributor. Drawing from the culture-centered approach to health communication and narrative theory, the present study explores African American patients and caregivers' experiences with hospice care and takes an initial step toward addressing disparities in end-of-life care. I begin this study, first, …