Medicine and Health Sciences Commons^™

Preventing Hepatitis B-Induced Liver Cancer: Implications For Eliminating Health Disparities, Moon S. Chen Jr.

Journal of Health Disparities Research and Practice

If the definition of eliminating of a health disparity were signified by the absence of any differences in incidence or mortality between a population’s experiences with a health problem, then the only health disparity that has ever been eliminated is smallpox because with zero cases of smallpox in the world, no health disparities exist because of smallpox. The eradication of smallpox is perhaps the only historical example where the elimination of a health disparity has been achieved. Principles and lessons learned, particularly through the intersection of science and policy that could be applied to the elimination of other health disparities …

Physical Activity Effects On Depressive Symptoms In Black Adults, Elisa R. Torres, Carolyn M. Sampselle, Kimberlee A. Gretebeck, David L. Ronis, Harold W. Neighbors

Journal of Health Disparities Research and Practice

Objectives: Randomized trials found physical activity (PA) effective in decreasing depressive symptoms. Few studies included Black participants. The purpose of this systematic literature review was to determine the effects of PA on depressive symptoms in Black adults. Methods: Articles were abstracted by conducting a computer and hand search of eligible studies. Results: Eight of 13 studies found a significant inverse relationship between PA and depressive symptoms in Black adults. Sources for the heterogeneity were explored. Conclusion: Future studies should include representative samples of Black adults, incorporate a theory which considers multiple levels of influence, account for genetic factors in the …

Perceptions Of Healthcare, Health Status, And Discrimination Among African-American Veterans, Nathaniel Rickles, Silvia Dominguez, Hortensia Amaro

Journal of Health Disparities Research and Practice

The Institute of Medicine identified access to healthcare and race-based discrimination as important barriers to quality healthcare that contributes to health disparities. This study (1) describes African-American veterans’ perceptions of healthcare services and perceived discrimination in healthcare and (2) investigates the relationship between perceived discrimination and patient perceptions of care, satisfaction with healthcare, and health status. A convenience sample of 141 African-American veterans in Boston completed surveys from May to June 2006.

Respondents reported an average of 16 lifetime experiences of discrimination and over half recalled a situation when they experienced discrimination in healthcare. Modest ratings of perceived quality of …

Preventable Asthma Episodes Among Urban/Rural Children And Adolescents: A Comparative Study, Saundra Glover, Crystal N. Piper, Edith Williams, Kevin Bennett, Winifred Thompson, Lucy Annang, Shaniece Charlemagne, Rahnuma Hassan

Journal of Health Disparities Research and Practice

Context: Asthma is a chronic respiratory illness that is increasing in prevalence among children in the United States. A limited number of studies have examined the relationship between rurality and the prevalence of asthma in minority children, and those studies found mixed results. The aim of this study is to examine urban/rural locality and its impact on asthma episodes and preventable emergency department visits, and to provide quantitative evidence concerning the relationship between patient characteristics and geographic location. Methods: This is a retrospective study and secondary data analysis of the 2000 National Health Interview Survey. Parametric testing using Univariate/Bivariate/Multivariate analysis …

Colorectal Cancer Screening Behaviors Among American Indians In The Midwest, Christine M. Daley, Niaman Nazir, K. A. Greiner, Aimee S. James, Won S. Choi

Journal of Health Disparities Research and Practice

Colorectal cancer is the second most diagnosed cancer among American Indians and is also the second leading cause of cancer death. We used a community-based participatory approach to conduct a mixed methods study to examine colorectal cancer screening behaviors. Here we report on the screening behaviors of our focus group participants (n=153). There were significant gender differences in the colorectal cancer screening rates for FOBT and colonoscopy. Although over 80% of participants reported having health insurance, only 35% of males over 50 years old and 57% of females reported ever having a colonoscopy. More research is needed to identify the …

Determinants Of Depressive Symptoms Among Women On Public Assistance In Louisiana, Theresa C. Davidson, Joachim Singelmann

Journal of Health Disparities Research and Practice

Depression can be a significant barrier in the welfare-to-work transition of poor women. Fortunately, support from social networks can lessen symptoms and facilitate entry into the workplace. Inconsistency in the literature concerning the effects of social networks on the poor suggests further research is needed. Thus, we examine the level and determinants of depressive symptoms among participants in the Temporary Assistance to Needy Families program. Having a good job, being in good health, married, and black, and living in rural areas inhibit symptoms of depression. Remaining on TANF and having several children increases symptom levels. Those who report that they …

Social Capital And Violence Across Racial And Ethnic Samples Of Adolescents, Darlene R. Haff, Kevin M. Fitzpatrick, H. H. Floyd

Journal of Health Disparities Research and Practice

Using a national sample of adolescents, results of this study demonstrate the important role family and school social capital plays in protecting both White and selected non- White students against violent outcomes. For example, parent-child relationship was associated with reduced violence for Black and White adolescents but not for Hispanics. School affiliation was significant in models for Hispanic and White adolescents but not in models for Black students. Sports participation was associated with greater violence among Hispanics and Whites, but not Blacks. Interestingly, club participation was significant for Whites, but, like sports, it was associated with greater violence. Parental monitoring …

Research Brief: "Military Training And Personality Trait Development: Does The Military Make The Man, Or Does The Man Make The Military?", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about whether students who join the military in Germany have a difference in personality compared to those who do not, and whether military service changes service members' personalities. In practice and policy, policymakers should consider how military experience affects service members' long-term health and well-being. Suggestions for future research include also studying female service members and expanding the sample to other countries to see whether the same effects occur in other countries' military personnel.

Application Of A Re-Aim Framework To Assess The Impact Of The Southwest American Indian Collaborative Network, Michelle Chino, Carolee Dodge Francis

Journal of Health Disparities Research and Practice

In response to a Request for Proposals from the National Cancer Institute (NCI), the Inter Tribal Council of Arizona (ITCA) along with health care partners from the Phoenix Indian medical Center (PIMC) and academic partners from the Arizona Cancer Center (ACC) at the University of Arizona (UA), and the University of Nevada Las Vegas (UNLV) established a Community Network Program entitled the Southwest American Indian Collaborative Network (SAICN). The ultimate goal of the SAICN project was to “eliminate cancer health disparities by closing the gap between the health needs of the community and cancer prevention and control made possible by …

Not Always Black And White: Racial Bias For Birth Disparities From Excluding Hispanic Identification, Barbara L. Wilson, Cristi Coursen, Matthew Butler

Journal of Health Disparities Research and Practice

Despite gains in prenatal care (PNC) usage and birth outcomes for minority women during the past few decades, observed disparities between non-Hispanic Whites, Blacks, and Hispanics persist. Using the National Center for Health Statistics’ (NCHS) natality files from 1981 through 1998, Alexander, Kogan, & Nabukera (2002) examined live births of U.S. residents by trimester in which PNC was initiated and the appropriateness of that care based on the Adequacy of Prenatal Care Utilization Index (APNCU) (Kotelchuck, 1994). They found racial disparities between White and Black women in both the trimester of PNC initiation and the number of PNC visits made. …

A Su Salud En Acción: Replicating A Model To Increase Utilization Of Cancer Screening Among Low Income Latinas, Amelie G. Ramirez Drph, Patricia Chalela, Lucina Suarez, Kipling J. Gallion

Journal of Health Disparities Research and Practice

Latinas suffer longstanding disparities in breast cancer survival and cervical cancer incidence and mortality compared to non-Hispanic white women. This study assessed the feasibility of replicating the theory-based A Su Salud En Acción communication model to impact cancer screening behaviors in two at-need Nevada clinics. The intervention significantly increased the number of mammograms and Pap smears among Latinas. Mammograms and Pap smear rates increased by 58.7‰ and 51.8‰ respectively in the pilot site (95% CI 40.1-49.1 and 47.1-56.5 respectively) and by 33.7‰ and 7.5‰ respectively (95% CI 15.6-51.9 and 4.3-10.6) in the replication site, among women ages 50-64.

This study …

Participant Recruitment Of African American College Students At An Historically Black College And University (Hbcu): Challenges And Strategies For Health-Related Research, Cecile N. Yancu, Anna K. Lee, Daphne D. Witherspoon, Correll D. Mcrae

Journal of Health Disparities Research and Practice

Lack of research participation among African Americans is problematic for population relevant health disparity research. The purpose of this paper is to identify and describe challenges and strategies in recruitment of African American college students for health related research being conducted at a small Historically Black College or University (HBCU). Upon completion of a recruitment and retention literature review, study investigators constructed and tested a culturally-specific, direct-appeal protocol to recruit participants. Major barriers to recruitment of African American college students included discrete sources of distrust, lack of understanding of the research process, and logistical concerns. Implementation of a culturally-specific, direct …

Walking Increases Among African American Adults Following A Community-Based Physical Activity Intervention: Racial And Ethnic Approaches To Community Health, 2002–2005, I. W. Miles, J. Kruger, Y. Liao, S. A. Carlson, J. E. Fulton

Journal of Health Disparities Research and Practice

Racial and Ethnic Approaches to Community Health (REACH) 2010, a communitybased program, is a cornerstone of CDC’s efforts to eliminate racial and ethnic health disparities. Six African American REACH sites implemented walking interventions as part of their plans to decrease health disparities. We evaluated changes in walking using annual evaluation assessments (2002–2005) from the REACH 2010 Risk Factor Survey. Walking was classified 3 ways: (1) any walking (≥ 10 minutes per week); (2) regular walking (≥ 30 minutes each day, ≥ 5 days per week); and (3) median minutes of walking per week. Any walking increased from 68.3% in 2002 …

Self-Stigma, Stress, And Smoking Among African American And American Indian Female Smokers: An Exploratory Qualitative Study, Diana Burgess, Rachel Widome, Michelle Van Ryn, Sean Phelan, Steven Fu

Journal of Health Disparities Research and Practice

Research suggests that negative emotions and difficulty coping with stressful events might impede women’s ability to quit smoking. This study uses qualitative methods to explore interrelationships between smoking behavior and negative emotions among a sample of racial/ethnic minority female smokers with the aims of theory-building and hypothesis generation. Data were derived from a larger study involving sixteen focus groups with current and former smokers from ethnic minority communities. The present study consisted of three focus groups of female African American and American Indian smokers (N = 16). Data was analyzed following standard methods for in vivo coding of qualitative data. …

Asthma Management: An Ecosocial Framework For Disparity Research, Robin A. Evans-Agnew

Journal of Health Disparities Research and Practice

Background: Asthma management disparities (AMD) between African and White Americans are significant and alarming. Various determinants have been suggested by research frameworks that affect the unfair distribution of resources for asthma management to groups who are more or less advantaged socially. Ecosocial models organize determinants into individual/family, healthcare, community, and sociocultural levels. Multilevel interventions can affect AMD through simultaneous actions on different levels and pathways between determinants.

Objective: Provide a comprehensive summary of the known determinants of AMD.

Method: Peer reviewed research frameworks of AMD from 1998-2009 were retrieved from PubMed/ Web of Science databases using (“Socioeconomic Factors”[Mesh] OR (“Healthcare …

Substance Abuse Treatment Stage And Personal Networks Of Women In Substance Abuse Treatment, Elizabeth M. Tracy, Hyunsoo Kim, Suzanne Brown, Meeyoung Oh Min, Min Kyoung Jun, Christopher Mccarty

Social Work Faculty Publications

This study examines the relationship among 4 treatment stages (i.e., engagement, persuasion, active treatment, relapse prevention) and the composition, social support, and structural characteristics of personal networks. The study sample includes 242 women diagnosed with substance dependence who were interviewed within their first month of intensive outpatient treatment. Using EgoNet software, the women reported on their 25 alter personal networks and the characteristics of each alter. With one exception, few differences were found in the network compositions at different stages of substance abuse treatment. The exception was the network composition of women in the active treatment stage, which included more …

Breast Cancer Screening Practices Among American Indians And Alaska Natives In The Midwest, Christine M. Daley, Melissa Filippi, Aimee S. James, Sarah Brokenleg, Stacy Braiuca, K. A. Greiner, Won S. Choi

Journal of Health Disparities Research and Practice

American Indian and Alaska Native (AI/AN) women currently have some of the highest mortality rates from breast cancer for any racial/ethnic group in the United States and some of the lowest screening rates. However, current data are not available for regional differences in screening, which can result in dramatically different stage at diagnosis and mortality. We conducted surveys with 120 focus group participants in a needs assessment of mammography among AI/AN in the greater Kansas City metropolitan area and parts of Northeast Kansas. We found that among women under age 40, for whom recommended screenings include only annual clinical breast …

Race And Hepatitis C Management Within The Veterans Administration, Joahd Toure, Joshua Metlay, Sandford Schwartz, Knashawn Morales, David Kaplan, Peter Groeneveld

Journal of Health Disparities Research and Practice

Objective: To examine black-white differences in hepatitis C treatment within the Veterans Administration (VA) and determine whether racial variation in specialty consultation explains differences in hepatitis C treatment between blacks and whites.

Methods: We performed a retrospective cohort study of 1040 veterans meeting VA eligibility criteria for hepatitis C treatment. We used multiple imputation to handle missing race data. Specialty consultation was determined from the VA outpatient medical dataset and hepatitis C treatment was determined from the VA decision support system. Conditional logistic regression was used to examine the association between race and hepatitis C treatment as well as race …

Spiritual Care Within Oncology Care: Development Of A Spiritual Care Program At An Indian Health Service Hospital, Catherine Witte, Tamana D. Begay, Kathryn Coe

Journal of Health Disparities Research and Practice

Spiritual care is essential in providing quality health care for patients and their families and is supported in the mission of the Indian Health Service (IHS). Their mission is to raise the physical, mental, social and spiritual health of American Indians and Alaska Natives to the highest level. This paper will describe the spiritual care programs at the Phoenix Indian Medical Center, an IHS hospital located in Phoenix, Arizona. Two hospital committees, the Volunteer Chaplains’ Association and the Traditional Cultural Advocacy Committee, provide spiritual care for the medical center and work to sustain a presence of spiritual and cultural awareness …

Poverty And Mortality Disparities In Central Appalachia: Mountaintop Mining And Environmental Justice, Michael Hendryx

Journal of Health Disparities Research and Practice

Objectives. This study investigated the associations between poverty rates, Appalachian mountaintop coal mining, and age-adjusted total mortality rates to determine if persons exposed to this form of mining experience greater poverty and higher death rates compared to other types of mining or other areas of Appalachia.

Methods. Mortality rates, poverty rates, Appalachian designation and mining activity were examined for counties in Kentucky, Tennessee, Virginia and West Virginia (N=403). Linear least squares models tested for annual group differences from 2000-2007 in total and child poverty, and total mortality, based on mining type and Appalachian location. Nested linear models accounting for state-level …

Value Of Community Partnership For Understanding Stress And Coping In Rural Yup’Ik Communities: The Canhr Study, Inna D. Rivkin, Ellen Lopez, Tonie M. Quaintance, Joseph Trimble, Scarlett Hopkins, Candace Fleming, Eliza Orr, Gerald V. Mohatt

Journal of Health Disparities Research and Practice

Stress and trauma can compromise physical and mental health. Rural Alaska Native communities have voiced concern about stressful and traumatic events and their effects on health. The goal of the Yup’ik Experiences of Stress and Coping Project is to develop an in-depth understanding of experiences of stress and ways of coping in Yup’ik communities. The long-range goal is to use project findings to develop and implement a community-informed and culturally grounded intervention to reduce stress and promote physical and mental health in rural Alaska Native communities. This paper introduces a long-standing partnership between the Yukon-Kuskokwim Regional Health Corporation, rural communities …

Does Access To A Family Physician Matter For Adolescents?, Bridget L. Ryan, Moira Stewart, M. Karen Campbell, John Koval, Amardeep Thind

RDC@Western Research Highlights

No abstract provided.

The Significance Of Race For Neighborhood Social Cohesion: Perceived Difficulty Of Collective Action In Majority Black Neighborhoods, Tamara Leech, Tara Hobson-Prater

Department of Public Health Scholarship and Creative Works

This article explores William Julius Wilson's contentions about community cultural traits by examining racial differences in middle class neighborhoods' levels of social cohesion. Specifically, we explore the perceived difficulty of these actions-as opposed to general pessimism about their outcomes-as a potential explanation for low levels of instrumental collective action in Black middle class neighborhoods. Our results indicate that, regardless of other neighborhood factors, majority Black neighborhoods have low levels of social cohesion. We also find that this racial disparity is statistically explained by shared perceptions about the amount of effort required to engage in group action in different neighborhoods. These …

Gender Identity, Ethnic Identity, And Smoking Among First Nations Adolescents, Lorraine Greaves, Joy Johnson, Annie Qu, Chizimuzo T.C. Okoli, Natalie Hemsing, Lucy Barney

Nursing Faculty Publications

Smoking rates among Aboriginal adolescents are the highest of any population group in British Columbia, Canada. Recent studies suggest that substance use is affected by gender and ethnic identity among youth. The purpose of our study was to explore the association of gender and ethnic identity with smoking behaviour among First Nations adolescents. This study is based on a convenience sample (i.e., an on-hand, readily available sample) of 124 youth (123 First Nations and 1 Métis) recruited at youth drop-in centres, health fairs, and cultural activities. We obtained information on demographics, smoking history, Bem Sex Role Inventory (BSRI), composite measure …

Research Brief: "Bmi Trajectory Groups In Veterans Of The Iraq And Afghanistan Wars", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about obesity rates among OEF/OIF veterans and how race, education level, gender, and use of the VA play a role in obesity rates. For practice and policy, a fitness education program should be implemented by the VA to help lower obesity rates since obesity can cause more serious health problems. Suggestions for future research include expanding the study to involve veterans from other military eras and expanding the study to look at more risks associated with obesity.

Lithium Treatment Of Appswdi/Nos2−/− Mice Leads To Reduced Hyperphosphorylated Tau, Increased Amyloid Deposition And Altered Inflammatory Phenotype, Tiffany L. Sudduth, Joan G. Wilson, Angela Everhart, Carol A. Colton, Donna M. Wilcock

Sanders-Brown Center on Aging Faculty Publications

Lithium is an anti-psychotic that has been shown to prevent the hyperphosphorylation of tau protein through the inhibition of glycogen-synthase kinase 3-beta (GSK3β). We recently developed a mouse model that progresses from amyloid pathology to tau pathology and neurodegeneration due to the genetic deletion of NOS2 in an APP transgenic mouse; the APPSwDI/NOS2-/- mouse. Because this mouse develops tau pathology, amyloid pathology and neuronal loss we were interested in the effect anti-tau therapy would have on amyloid pathology, learning and memory. We administered lithium in the diets of APPSwDI/NOS2-/- mice for a period of eight months, followed by water maze …

Discerning Reported Suicide Attempts Within A Youthful Offender Population, Christopher A. Mallett, Leaanne Derigne, Linda M. Quinn, Patricia A. Stoddard Dare

Social Work Faculty Publications

With suicide being the third leading cause of death among young people, early identification of risk is critical, particularly for those involved with the juvenile courts. In this study of court-involved youth (N = 433) in two Midwest counties, logistic regression analysis identified some expected and unexpected findings of important demographic, educational, mental health, child welfare, and juvenile court-related variables that were linked to reported suicide attempts. Some of the expected suicide attempt risk factors for these youth included prior psychiatric hospitalization and related mental health services, residential placement, and diagnoses of depression and alcohol dependence. However, the most unexpected …

Update - February 2012, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Cancer Stories: An Argument for Narrative Ethics
-- Dual-Degree Masters of Arts in Bioethics
-- From the Director
-- Finding a Voice for Seventh-day Adventist Ethics in the Radical Reformation?

Type 2 Diabetes Science And American Indian / Alaska Native Culture: Creating A National K-12 Curriculum Prevention Strategy For Native Youth, Carolee Dodge Francis, Michelle Chino

Environmental & Global Health Faculty Research

Preventing and reducing the onset of type 2 diabetes among American Indian/Alaska Native youth requires educational strategies to affect knowledge, attitudes, and cognitive decision-making skills. In an unparalleled effort to address the growing epidemic of type 2 diabetes in tribal communities, eight tribal colleges and three federal agencies collaborated to develop and implement a kindergarten-through-twelfth-grade (K–12) Diabetes Education in Tribal Schools curriculum. This article outlines the scientific and cultural development of a comprehensive K–12 science curriculum as a targeted health prevention strategy.

Increasing Consumer Involvement In Medicaid Nursing Facility Reimbursement: Lessons From New York And Minnesota, Edward Alan Miller, Cynthia Rudder

Gerontology Institute Publications

Medicaid is the major purchaser of nursing home care in the United States. States design their methods of reimbursing nursing homes to achieve desired policy objectives related to facility cost and quality, access to care, payment equity, service capacity, and budgetary control. The incorporation of multiple, sometimes conflicting incentives into state reimbursement systems has resulted in enormously complex and demanding methodologies that inhibit consumer participation in state rating setting decisions. In turn, the lack of consumer involvement has the potential to result in the adoption of reimbursement systems that favor industry and government interests at the expense of issues important …