Medicine and Health Sciences Commons^™

An Interpretive Phenomenological Analysis Exploring African American Women’S Perceptions Of Access To Healthcare In The Midwest, Ramona D. Benson

Doctoral Dissertations and Projects

The purpose of this interpretive phenomenological study was to explore access to healthcare through the lens and lived experiences of African American Women (AAW) in Midwestern towns throughout the United States. African American women and other people of low socio-economic backgrounds continue to live with poorer health outcomes than many of their counterparts African American Women experience barriers to healthcare from a unique perspective than their White counterparts. Although medical professionals endeavor to attain equal treatment among each of their patients, significant healthcare disparities are prevalent among AAW Commonly recognized ethnic stereotypes are not always intentionally supported, however, their mere …

The Consequences Of Homophobia: Analysis Of Discriminatory Medical And Legislative Policies And Their Influence On Health Disparities, Kaiden J. Fandel

Honors Thesis

Are there specific roots that influence the introduction and incorporation of discriminatory medical policies? What are the sources of such stigma, discrimination, and prejudice, in what forms does such discrimination take place, and what negative impacts does such hatred have on health outcomes, quality of care, and health disparities? Through a review of existing literature on this topic, intertwining the examination of the evolution of discriminatory policies and other explanatory literature in the United States, this thesis aims to answer the questions above, and explain the roots of such homophobic discrimination and its prevalence in the United States. Through the …

The Relationship Between Cancer Screening Utilization And Racial Discrimination: A Systematic Review, Priya Small, Amanda M. Hinson-Enslin, Timothy Crawford, Joanna Anderson

Journal of Ideology

Objective. To assess literature about cancer screening and cancer screening adherence among people of color and how discrimination impacts cancer screening and cancer screening adherence outcomes among patients of color.

Methods. PRISMA guidelines were used for the systematic review. EBSCO/MEDLINE, Web of Science, and CINAHL were searched and articles were uploaded in to Rayyan Systematic Review software. Three independent reviewers identified additional articles by searching reference lists of relevant articles; they completed the screening process and reviewed the included articles.

Results. Nine eligible studies were included, among which two were qualitative and seven were quantitative. Studies included one cancer screening …

Influences On Pregnancy: An Exploration Of Maternal Discrimination, An Alternative Model Of Prenatal Care And Health Information Online, Emily Doherty

All Dissertations

In the United States metrics of perinatal health lag far behind peer countries and is characterized by stark disparities. The studies that make up this dissertation seek to elucidate factors influencing perinatal health.

The first and second chapters provide an introduction and extensive review of the literature of factors contributing to perinatal health with specific focus on discrimination and perinatal health; group prenatal care and digital pregnancy health information. The third chapter introduces the methodology to be used by each of the following studies. Subsequent chapters are formatted as individual manuscripts, each presenting background, methodology, results, and discussion.

The fourth …

Racial Differences In Perception And Experiences Of Adverse Treatment By Healthcare Providers: A Cross-Sectional Analysis Of The All Of Us Data, Tanya Funchess, Traci Hayes, Yang Ge, Felix Twum

Journal of Public Health in the Deep South

Health disparities among racial and ethnic groups in the U.S. are well documented. Among the non-medical issues, including discrimination, language barriers, and low health literacy, the patient-provider relationship has been identified as a factor that drives health disparities. Negative interactions with healthcare providers and the healthcare system produce poor health outcomes, exacerbating health inequalities and reducing the likelihood of patients adhering to recommended treatments and therapies. The purpose of this study was to examine racial differences in perceptions and experiences of adverse treatment by healthcare providers. A cross-sectional analysis of select variables from the All of Us research program basic …

Experiences Of Covid-19-Related Racism And Impact On Depression Trajectories Among Racially/Ethnically Minoritized Adolescents, Sabrina R. Liu, Elysia Poggi Davis, Anton M. Palma, Hal S. Stern, Curt A. Sandman, Laura M. Glynn

Psychology Faculty Articles and Research

Purpose

In 2020, racially/ethnically minoritized (REMD) youth faced the “dual pandemics” of COVID-19 and racism, both significant stressors with potential for adverse mental health effects. The current study tested whether short- and long-term trajectories of depressive symptoms from before to during the COVID-19 pandemic differed between REMD adolescents who did and did not endorse exposure to COVID-19-era-related racism (i.e., racism stemming from conditions created or exacerbated by the COVID-19 pandemic).

Methods

A community sample of 100 REMD adolescents enrolled in an ongoing longitudinal study of mental health was assessed before and during the COVID-19 pandemic. Participants were 51% girls, mean …

An Examination Of Discrimination On Stress, Depression, And Oppression-Based Trauma During The Covid-19 Pandemic And The Racial Awakening Of 2020, Ardhys N. De Leon, Jacqueline Woerner, Robert D. Dvorak, Jonathan Cox, Tatiana D. Magri, Emma R. Hayden, Manik Ahuja, Angela M. Haeny

ETSU Faculty Works

Background

Methods

Understanding The Interconnection Between Public Health And Political Behaviors In A Politically Polarized Context: The Impact Of Race, Political Attitudes, And Policy Factors On The Us Covid-19 Pandemic Response., Florent Nkouaga

Political Science ETDs

This dissertation evaluates the interconnection between health and political behaviors in a polarized context such as the United States. The COVID-19 pandemic unveiled the current political polarization and the structural health disparities among racial communities. Using the system theory delineated by David Easton, this dissertation demonstrates that health attitudes and behaviors in the electorate can influence voting behaviors, as was the case with the 2020 US presidential election. An evaluation of the 2021 African American COVID-19 Vaccine Polls (AACVP), and the 2020 Collaborative Multiracial Postelection Survey (CMPS) demonstrates that factors such as public health compliance, trust in federal health institutions, …

Mental Health Burden Among College Students During Covid-19 Pandemic: A Cross-Sectional Study, Jeffrey Bao Truong

Electronic Theses, Projects, and Dissertations

Background: The COVID-19 pandemic is a significant public health issue and has negatively burdened the general population’s health, though assessment among vulnerable groups remain limited. The present study aimed to evaluate the mental health burden of the COVID-19 pandemic among college students.

Method:This study utilized a cross-sectional approach. Courses across multiple departments were used to collect data in order to ensure a diversity of majors. All statistical analyses were conducted using SPSS version 28 with p <.05 denoting significance.

Results: A total of 98 study participants were included in analyses. Among study participants, 32%reported feeling their mental health worsened due to COVID-19 …

Exploring The Experience Of Stigma Among People Living With Hiv In Bali, Indonesia: Qualitative Phenomenological Study, Jufri Hidayat, Xuan-Yi Huang, Hung-Ru Lin, Shiow-Jing Wei, Miao-Yen Chen, Satriya Pranata

Makara Journal of Health Research

Background: Human immunodeficiency virus (HIV)-related stigma continues to be a serious problem for people living with HIV (PLWH). This study aimed to explore stigma experience among PLWH in Bali, Indonesia.

Methods: This research was a qualitative descriptive phenomenological study. With the help of a local clinician–researcher and the staff of the United Nations Program on AIDS Commission, Bali, 10 participants were recruited by purposive sampling and participated in semi-structured interviews via WhatsApp online audio from April to December 2021. Data were analyzed using Colaizzi’s process.

Results: The following three themes emerged: (1) experiencing discrimination, (2) getting stronger …

Intergenerational Risk And Resilience Pathways From Discrimination And Acculturative Stress To Infant Mental Health, Sabrina R. Liu, Curt A. Sandman, Elyssia Poggi Davis, Laura M. Glynn

Psychology Faculty Articles and Research

Preconception and prenatal stress impact fetal and infant development, and women of color are disproportionately exposed to sociocultural stressors like discrimination and acculturative stress. However, few studies examine links between mothers’ exposure to these stressors and offspring mental health, or possible mitigating factors. Using linear regression, we tested associations between prenatally assessed maternal acculturative stress and discrimination on infant negative emotionality among 113 Latinx/Hispanic, Asian American, Black, and Multiethnic mothers and their children. Additionally, we tested interactions between stressors and potential pre- and postnatal resilience-promoting factors: community cohesion, social support, communalism, and parenting self-efficacy. Discrimination and acculturative stress were related …

Inclusive, Supportive And Dignified Maternity Care (Sdmc)-Development And Feasibility Assessment Of An Intervention Package For Public Health Systems: A Study Protocol, Bilal Iqbal Avan, Waqas Hameed, Bushra Khan, Muhammad Asim, Sarah Saleem, Sameen Siddiqi

Community Health Sciences

Introduction: Mistreatment, discrimination, and poor psycho-social support during childbirth at health facilities are common in lower- and middle-income countries. Despite a policy directive from the World Health Organisation (WHO), no operational model exists that effectively demonstrates incorporation of these guidelines in routine facility-based maternity services. This early-phase implementation research aims to develop, implement, and test the feasibility of a service-delivery strategy to promote the culture of supportive and dignified maternity care (SDMC) at public health facilities.
Methods: Guided by human-centred design approach, the implementation of this study will be divided into two phases: development of intervention, and implementing and testing …

It Cannot Happen, Never: A Qualitative Study Exploring Youth Views On Disclosure Of Hiv Diagnosis To Their Sexual Partners In Southern Malawi, Maggie Zgambo, Diana Arabiat, Deborah M. Ireson Dr

Research outputs 2014 to 2021

With the availability of antiretroviral therapy, more children living with HIV live longer than before and grow into young adulthood. This study examined the concerns of youth about disclosure of an HIV diagnosis to their sexual partners and attempted to gain an understanding of their HIV status disclosure experiences, views, and plans. A focused ethnography was undertaken. Using semi-structured interviews, data were collected from 20 youth between the ages of 15 and 24 years who were attending an HIV clinic. The findings highlight that youth generally struggled to disclose their HIV status to their sexual partners. The most frequent reasons …

Black And White Health Disparities: Racial Bias In American Healthcare, Yasmeen Almomani

Bridges: An Undergraduate Journal of Contemporary Connections

This paper explores the historical implications of race in American society that have led to implicit racism in the healthcare system. Racial bias in healthcare against Black people is a factor in the health disparities between Black and white people in America, such as the gap in life expectancy, infant death, and maternal mortality. Black people are more likely to report racial discrimination from healthcare providers, which is a reason for the decreased quality of care received. The past justifications of slavery, the Tuskegee syphilis study, and the medical experimentations on Black women are horrifying but were considered acceptable in …

Examining The Effect Of Provider Bias On Pain Management In Black Patients: A Systematic Literature Review, John Massey, Monica Gambilado

Thinking Matters Symposium

Black Americans face unequal treatment for pain management when seeking care. The aim of this systematic literature review is to examine the impact of provider bias on Black patients receiving appropriate pain management interventions in the clinical setting. This review followed the Preferred Reporting Items for Systematic Literature Reviews and Meta-Analysis guidelines. CINAHL and PubMed were searched with the following key search terms: Black/African American, bias, prejudice, discrimination, unconscious bias, pain management, pain reduction, pain control and analgesic. A self-developed Critical Appraisal Tool was used for quality assessment of the studies included in the review. A total of 101 probable …

Race And Disordered Eating: A Narrative Review Of Current Literature, Casey Swann, Msed, Lee Pachter, Do, Elizabeth Liveright, Md, Meghan Gannon, Phd, Msph

Phase 1

Research Problem: Eating disorder literature has well-established a correlation between childhood trauma and development of eating disorder symptomology. One type of trauma that is often overlooked in eating disorder research is that of racial stress faced by ethnic minorities. The literature on racism and eating disorders tends to focus on the transdiagnostic construct of disordered eating behavior rather than specific DSM-5 diagnoses. As such, the current literature review examined the findings regarding associations between racial stressors and disordered eating behavior.

Methods: The current literature review between Nov 2007 and August 2020 searched 3 databases, PubMed, CINAHL, and PsycInfo for …

Understanding And Promoting Racial Diversity In Healthcare Settings To Address Disparities In Pandemic Crisis Management, Azza Sarfraz, Zouina Sarfraz, Alanna Barrios, Kuchalambal Agadi, Sindhu Thevuthasan, Krunal Pandav, Manish Kc, Muzna Sarfraz, Pedram Rad, George Michel

Department of Paediatrics and Child Health

Background: Health disparities have become apparent since the beginning of the COVID-19 pandemic. When observing racial discrimination in healthcare, self-reported incidences, and perceptions among minority groups in the United States suggest that, the most socioeconomically underrepresented groups will suffer disproportionately in COVID-19 due to synergistic mechanisms. This study reports racially-stratified data regarding the experiences and impacts of different groups availing the healthcare system to identify disparities in outcomes of minority and majority groups in the United States.
Methods: Studies were identified utilizing PubMed, Embase, CINAHL Plus, and PsycINFO search engines without date and language restrictions. The following keywords were used: …

Social Determinants Of Discrimination And Access To Health Care Among Transgender Women In Oregon, Jonathan Garcia, Richard A. Crosby

Health, Behavior & Society Faculty Publications

Purpose: Transgender women in the United States experience health disparities and limited access to gender-affirming health services. This study describes the social determinants of health that shape access to health services for transgender women in Oregon, a state with a high tally of gender-affirming policies.

Methods: We conducted qualitative interviews with 25 transgender women between 18 and 39 years of age. Interviews explored the social, economic, cultural, and legal factors that shape access to health. A Qualtrics survey captured sociodemographic characteristics. We identified facilitators and barriers to accessing gender-affirming services using thematic analysis of qualitative data.

Results: Our participants perceived …

Physical Education And Anti-Blackness, Brian Culp

Faculty Articles

This commentary is not intended to be an all-inclusive “catch-all” but a starting point to inspire behavior change, cultural fluency, and an “ideological repositioning” of how we think about our professional work. In defining anti-Blackness, the article provides perspectives from educational literature, research, and personal observations before providing a challenge to SHAPE America and all professionals involved in efforts related to the promotion of quality physical education.

Special Issue – July 2021 The Impact Of Inequity & Health Disparities On The Human Experience, Patient Experience Journal

Patient Experience Journal

Patient Experience Journal (PXJ) is excited to announce the call for submissions for its July 2021 special issue on the impact of racial inequality, health disparities, and discrimination on the human experience. The world now finds itself in the grips of a global pandemic that is taking its toll on communities socially and economically, placing strain on healthcare workers and revealing the very systemic weaknesses and inherent biases that have been resting just beneath the surface of our society for years. The challenge of disparity and inequity is not unique to healthcare, but in the era of COVID-19, what many …

Effects Of Latinx Parental English Proficiency On Stress, Maria Alvarez Pineda

Student Research Posters

In the United States, patients who have Limited English Proficiency (LEP) report having more problems communicating with their children’s doctors (Eneriz-Wieme et al., 2014) and experiencing more discrimination (Zhang et al., 2012) which can lead to increased psychological distress (Torres et al., 2012). The goal of this study was to determine if level of English Proficiency is related to stress levels and discrimination among Latinx parents. Participants consisted of 22 Latinx parents (86.4% Mexican and 90.9% female) in the San Francisco Bay Area. The Acute Stress Appraisals scale (Mendes, et al., 2007) measured parents' stress levels before and after an …

“Disbelieving Black Women To Death”; The “Double Jeopardy”: Racism And Sexism Affects Black Women’S Access To And Quality Of Care During Pregnancy, Birth, And Postpartum, Madeline St. Clair

Theses/Capstones/Creative Projects

This paper explores possible reasons why Black women in the United States experience a higher maternal mortality rate than their white counterparts. Using books, articles, journals, documentaries, personal experiences and stories of Black women and mothers, I argue that barriers from the societal to the individual level create health and medical disparities for Black mothers in pregnancy, during delivery, and the postpartum period. The paper concludes with a multifaceted solution and call to action.

Community Psychology's Impact On Public Health And The Experience Of Marginalization, Katie Hudick

Richard T. Schellhase Essay Prize in Ethics

Vulnerable and marginalized populations face a series of risks and dangers throughout their daily lives. This is not simply limited to explicit forms of discrimination and hatred, but systemic forms of oppression and discrimination which limit those not belonging to more privileged and affluent socioeconomic or sociocultural groups. Community psychology operates as a means of analyzing how environmental and social factors impact specific demographic groups within a larger population and by extension the experience of mental health specific to these groups (Townley, Brown, & Sylvestre, 2018). In the application of this field, it is critical to understand the dynamics of …

Discrimination, Coping, And Depression Among Black Men Who Have Sex With Men, Andre L. Brown, Jordan Sang, Leigh Bukowski, Steven Meanley, Byron D. Brooks, Cristian Chandler

Journal of Health Disparities Research and Practice

Black men who have sex with men (BMSM) have elevated risk for depression compared to the general population. BMSM’s capacity to cope with these experiences is not well understood. Increased understanding of how multiple forms of discrimination contribute to depression and how BMSM cope with discrimination can better inform interventions. Data come from 3,510 BMSM who attended Black Pride events in six U.S. cities from 2015-2017. Participants completed a health survey that ascertained their psychosocial health and resiliency profiles. Using multivariable logistic regression models, we tested the associations between type-specific discrimination (race, sexuality, HIV status) and depression. We then conducted …

Identifying Protective Factors In Response To Discriminatory Experiences Among Pregnant African American Woman, Effie Mathew, Krys Foster, Md

Phase 1

Adverse maternal-fetal health outcomes, such as low birth weight and preterm delivery, are disproportionately more likely among African-Americans than Non-Hispanic Whites. Experiences of discrimination have been hypothesized as a contributing factor to the large discrepancies in maternal-fetal health outcomes. It is well understood that with increased levels of self-reported discrimination, there are lower ratings of physical and mental health, and higher reporting rates of depressive symptoms; this relationship is stronger in women. In addition to this, skin tone has long been a marker for social class and opportunity, but research on skin tone as a risk factor for African Americans …

Effects Of Latinx Parental English Proficiency On Stress, Maria Alvarez Pineda

Global Public Health | Senior Theses

Background

In the United States, patients who have Limited English Proficiency (LEP) report having more problems communicating with their children’s doctor which leads to these children having worse health care access than those who have parents with a High English Proficiency (HEP). Parents with LEP also experience discrimination in this setting which can lead to increased psychological distress. The goal of this study was to determine if the level of English Proficiency is associated to stress levels and discrimination among Latinx parents when they take their chidlren to the doctor.

Methods

Participants consisted of 22 Latinx parents (86.4% Mexican and …

Offering Medical Providers Capacity And Competence In Caring For Transgender And Non-Binary Patients: Evaluation Of A Pilot Digital Training Program, Lexis Manzara

Master's Projects and Capstones

Purpose: Stigma and discrimination in health care settings contribute to health disparities for transgender and non-binary (TGNB) people. Evidence suggests that a lack of training on the care for transgender and non-binary TGNB patients in medical school curricula has contributed to providers feeling unprepared to provide quality care for this population. Health care providers have the opportunity to play a key role in the reduction of health disparities for TGNB patients.

Methods: Twenty-five health care providers completed the eight-module digital training program. Pre- and post-tests assessed provider knowledge, self-efficacy, preparedness, and behavior. Paired samples t-tests were conducted to compare pre-and …

Women’S Experiences With Prenatal Care: A Mixed-Methods Study Exploring The Influence Of The Social Determinants Of Health, Karen A. D'Angelo, Janelle K. Bryan, Brenda Kurz

Janelle K. Bryan

Background & Purpose: Racial and ethnic disparities pervade birth outcomes in the United States and the state of Connecticut. While Connecticut’s infant mortality rate is less than the national average, rates for the state’s Black/African American and Hispanic/Latino communities exceed it. This study explored how prenatal care in Connecticut may be enhanced to address these disparities.

Methods: In spring 2013, seven focus groups and two semi-structured interviews were conducted (n=47). Participants also self-administered brief surveys. Recruited by local service providers, participants were 18 or older, pregnant and/or in the first year post-partum at the time. Most self-identified as …

Addressing Lapses In Medical Education In Relation To Lgbtqia+ Healthcare Disparities, Daniel Pinto, Aubrey Olson D.O.

Rowan-Virtua Research Day

As the LGBT community gains more visibility and acceptance, the individuals identifying as LGBTQIA+ have been increasing. Unfortunately for this community, healthcare disparities for LGBT individuals continue. In fact in a national online survey done with LGBTQIA+ physicians, 65% had heard discriminatory comments made towards LGBTQIA+ patients, and 34% witnessed discriminatory care given to LGBTQIA+ patients. (Bonvinci) Rose Chapman, a senior lecturer at Curtin University Nursing School, contributed this discomfort that medical professionals seem to have with LGBTQIA+ families with socioeconomic background such as religious beliefs or familiarity with the topic. (Chapman) Nevertheless, another study published by the Medical Journal …

"Disgusted With Myself": Examining The Risk Factors And Vulnerabilities Of Hostesses At Karaoke Tv Venues In Phnom Penh, Cambodia, Glenn M. Miles, Daphne Alsiyao

Dignity: A Journal of Analysis of Exploitation and Violence

This exploratory study is one of a series of research projects interviewing survivors of sexual exploitation in southeast Asia. It assesses the risk factors and vulnerabilities of young women in Karaoke TV (KTV) venues in Phnom Penh, Cambodia. This research study assesses the risk factors and vulnerabilities of young women in these venues. A questionnaire-based survey was administered to 50 participants to gain a holistic view of the lives of young women working in Karaoke TV (KTV) venues. The survey consisted of a series of questions pertaining to demographics, family background, prejudice and discrimination, sexual risk factors, substance abuse, sexual …