Medicine and Health Sciences Commons^™

An Initiative To Improve Cultural Competence Among Gyn/Ob Providers, Lynn R. Mcdonald, Joshua L. Schwarz, Stephen J. Martin, Susan Brown Will, Shari M. Lawson, Tanesha Stokes, Shannon C. Riley, Katie Reynolds, Betty Chou

Journal of Health Disparities Research and Practice

Healthcare cultural competence is defined as a process of delivering care by meeting the social, cultural, and linguistic needs of diverse populations, and should be optimized at all organizational levels to reduce racial disparities and poor patient outcomes. The American College of Obstetrics and Gynecology (ACOG) recognizes the importance of cultural competence and states that research should be conducted to identify and combat barriers that impede equitable care. In this prospective, pre- and post-intervention study design, we used the Healthcare Provider Cultural Competence Instrument (HPCCI) to measure five dimensions of cultural competence within the Department of Gynecology and Obstetrics in …

Sociodemographic Factors Associated With Attendance To Brighter Bites, A School-Based Food Co-Op Nutrition Intervention For Low-Income Families, Melinda R. Rushing, Ru-Jye Chuang, Christine Markham, Shreela V. Sharma

Journal of Health Disparities Research and Practice

Participants: The analytic sample included 6,796 participants from five of the six cities in which Brighter Bites was implemented (Houston, Austin, Dallas, Washington, D.C., and Southwest Florida).

Main Outcome Measures: Predictor variables included child’s grade, gender, race/ethnicity, parent employment, and government assistance utilization. Outcome variable was a binary measure of attendance: 1=attendance at or above the threshold or 0=attendance below the threshold, where the threshold was operationalized as attending 75% of the distributions.

Analysis: A multi-level logistic regression and bivariate analysis were completed to measure the association between attendance and predictor variables.

Results: Results show, compared to Hispanics, Whites were …

Understanding Disparities In Clinical Trials For Native Hawaiian Men, Gabriela A. Layi, Kevin Cassel, Maile Taualii, Jeffrey L. Berenberg, Erin O. Bantum

Journal of Health Disparities Research and Practice

Understanding low rates of participation by minority populations in clinical trials is critical for reducing and eliminating disparities. We examined beliefs and attitudes of Native Hawaiian men related to illness and cancer to better understand their rates of participation in clinical trials. We conducted face-to-face interviews with Native Hawaiian key informants throughout the State of Hawai‘i using quota sampling methods to obtain a range of perspectives about attitudes towards health care seeking to provide insight into low clinical trials participation. Interviews were audio-taped, transcribed, and independently coded by researchers. Thematic analysis guided the extraction of relevant data from the discussions. …

A Scoping Review Of Barriers And Facilitators To Pap Testing In Women With Disabilities And Serious Mental Illnesses: Thirty Years After The Americans With Disabilities Act, Michele S. Lee, Jillian R. Peart, Julie S. Armin, Heather J. Williamson

Journal of Health Disparities Research and Practice

Background: Thirty years after the Americans with Disabilities Act (ADA) was passed, promising equal access to health services for people with disabilities and serious mental illness, research on Pap testing continues to uncover health disparities among women with disabilities and women with serious mental illnesses, including those that identify as an ethnic/racial minority.

Aim: The purpose of this paper is to describe and present the literature on the barriers and facilitators women with disabilities and women with serious mental illnesses face with receiving a Pap test using the social ecological model. We also examined the degree to which …

The Intersection Of Hiv, Covid-19 And Systemic Racism, Gary F. Spinner

Journal of Health Disparities Research and Practice

ABSTRACT

The Human Immunodeficiency Virus (HIV) pandemic has taken the greatest toll on racial and ethnic minorities in the United States. Blacks and Latinxs suffer greater disease incidence, prevalence, morbidity and mortality from HIV as compared with Whites. Similarly, the Covid-19 pandemic caused by SARS-CoV-2 has disproportionately affected Blacks, Latinxs, and Native Americans causing higher rates of infection, more severe disease, and higher rates of mortality as compared with Whites. The pandemic of racism is as ubiquitous as the pandemics of HIV and Covid-19. Its sustaining forces drive wealth inequality, poverty, racially segregated and overcrowded housing, unequal employment opportunities, unequal …

Can Community Gardens With Workshops Increase Gardening Behavior? A Navajo Wellness Collaboration, Kevin A. Lombard Phd, India J. Ornelas Phd, Desiree Deschenie, Felix Nez, Sonia Bishop, Katie Osterbauer Ms, Eileen Rillamas-Sun Phd, Shirley A.A. Beresford Phd

Journal of Health Disparities Research and Practice

This paper seeks to evaluate the potential efficacy of a community gardening intervention on the Navajo Nation to increase gardening and healthy eating behaviors, which are potentially important in preventing obesity and related health conditions. Rates of obesity are high among American Indians, including those living on Navajo Nation land. Eating fresh fruits and vegetables is part of healthy eating. However, availability and access to fresh fruits and vegetables are severely limited on the Navajo Nation, due to distance and cost. One way to increase both availability and consumption of fresh fruits and vegetables is through community gardening, yet …

Prostate Cancer: Social, Economic And Demographic Correlates Of Non Use Of Supplemental Diets Among Black Men In Florida, Jemal Gishe, Getachew Dagne, Mohamed Kanu, Kushal Patel, Revlon Briggs, Folakemi Odedina, Francis Pleban

Journal of Health Disparities Research and Practice

Background: Epidemiologic data consistently show that Black men in the U.S. are disproportionately affected by prostate cancer. The incidence rate is 60% higher and death rate is 2.1 times more for Black men compared to Whites. There is growing evidence from literature that nutritional supplements, such as selenium, lycopene, vitamin A, vitamin D and soy may reduce the risk of prostate cancer. However, the level of knowledge and usage of these supplemental diets among Black men is low. Therefore, it is important to understand why Black men are low users of the supplemental diets and develop intervention programs to change …

Health Disparities And Covid-19 Pandemic: Increasing Clinical Research Participation Among African Americans, Kashica J. Webber-Ritchey, Abbi D. Lane-Cordova

Journal of Health Disparities Research and Practice

Health disparities in African Americans is a persistent issue. Higher rates and severity of the novel coronavirus-19 [COVID-19] among African Americans only widens health disparities. Effective COVID-19 treatment options are imperative, requiring representation of African Americans in clinical research. However, low participation and under-representation of African Americans is complex in nature. This article describes health disparities, the impact of COVID-19, and participation in clinical research among African Americans. We offer strategies for researchers to enhance the inclusion of African Americans. We also offer strategies in conducting clinical research during COVID-19.

Social Injustice And Pediatric Health: Pediatric Covid-19 Guidelines Are Exacerbating Health Disparities, Sneha Thamotharan

Journal of Health Disparities Research and Practice

Fewer cases of COVID-19 and hospitalizations have been reported in children. This has impacted the prioritization of pediatrics in understanding the infection, transmission, and treatment of SARS-CoV-2 in children. Unfortunately, COVID-19 rates are higher among racial and ethnic minoritized children. Simultaneously unfolding during this pandemic is a national outcry to address systemic injustice, including institutional racism in healthcare which are driving these disparities. Aligned with social justice, this paper reflects on how Pediatric COVID-19 guidelines may be exacerbating existing health disparities among racial and ethnic minoritized youth, as well as urges for and provides possible ways to culturally tailor current …

A Community-Based Participatory Research Project To Increase The Understanding Of The Health Concerns Of African Immigrant Communities In Urban Missouri., Rhonda Belue, Covenant Elenwo, Clayton Adams, Adaobi Anakwe, Kelly Taylor, Sunita Manu, Sidee Conteh

Journal of Health Disparities Research and Practice

Background

African immigrants and refugees experience unique mental and physical health care needs that may be a result of pre-migration history and the acculturation process. The purpose of this project was to collaborate with African immigrant and refugee communities to identify health needs of the communities and lay a foundation for future action.

Methods

Key-informant interviews with five West, East and Central African immigrant and refugee communities included community leaders (n=10) and listening sessions with larger groups of community members totaling approximately 150 participants to identify health care needs. Content analysis was employed to identify themes related to immigrant and …

Lessons From The Health Care Innovation Awards: Productively Engaging Vulnerable Populations To Address Social Determinants Of Health, Maysoun Freij, Megan Skillman, Caitlin Cross-Barnet, Rachel Friedman Singer, Christina Rotondo, Michelle Dougherty, Sarah Ruiz, Adil Moiduddin, Lynne Page Snyder

Journal of Health Disparities Research and Practice

Objectives: This paper examines productive interactions—a cornerstone of the Chronic Care Model—between health care providers and vulnerable populations with chronic illnesses and/or disabilities. Methods: We conducted qualitative analysis of 16 focus groups and 29 interviews with patients and/or caregivers and 195 interviews with program leadership and providers across 15 Health Care Innovation Awards that targeted vulnerable populations. We analyzed how awardees addressed health concerns and social determinants of health (SDOH), and identified key components of productive interactions. Results: Providers achieved productive interactions through four primary strategies: establishing trust and showing respect; solving problems; building accuracy in health …

Association Between Insurance Status And Hospital Outcomes Among Acute Kidney Failure Patients, Khoa Truong, Thuan Thai, Lingling Zhang, Lu Shi, C. Jason Wang

Journal of Health Disparities Research and Practice

Objectives: To investigate the relationship between insurance status and the risk of acute kidney failure (AKF) and consequential hospitalization outcomes.

Methods: A cross-sectional regression analysis was conducted for inpatients ages 18-64 in South Carolina 2012–2013. One dichotomous dependent variable - diagnosed with AKF at hospital admission, and two continuous dependent variables of hospital outcomes - total charge and length of stay, were examined. The key explanatory variable was the patient’s insurance status. Other covariates included patient’s age, gender, and race as well as AKF risk factors - Type 2 diabetic mellitus (T2DM), chronic kidney disease (CKD), hypertension, and proteinuria.

Results: …

Economic Insecurity As A Risk Factor During The Covid-19 Pandemic, Klaus E. Cavalhieri

Journal of Health Disparities Research and Practice

The novel coronavirus disease 2019 (COVID-19) is currently spreading at a rapid rate worldwide. The current pandemic may have several adverse effects on overall psychological functioning and health behaviors. Economic insecurity, operationalized as financial strain and employment uncertainty, can be a significant risk factor for both psychological outcomes and compliance with shelter-in-place recommendations (i.e., health behaviors). One hundred and twenty four participants answered survey data on economic security, fear of COVID-19, health care system distrust, anxiety, well-being, and compliance with CDC recommendations to curb the spread of COVID-19 (i.e., health behaviors; CDC, 2020). Economic security was significantly associated with well-being, …

The Culture Factor: The Effects On Healthcare Decisions Among Guyanese Men, Harrynauth Persaud

Journal of Health Disparities Research and Practice

Culture, religious beliefs, and ethnic customs, all play a role in how patients make healthcare decisions. As the racial and ethnic diversity continues to increase in the United States, so does the culture, religious beliefs, and customs. This research aims to explore the cultural and other influences on making healthcare decisions among Indo-Guyanese immigrant men. In-depth interviews were conducted among participants residing in the neighborhood areas of Queens, New York. Thorough qualitative analyses were performed on the data for which three major themes emerged. Family influences on health behaviors, the use of alternative medicines, and religious beliefs were found to …

An Opportunity To Partner With Community Organizations To Collect Data On Asian Americans, Victoria Wang, Karen Kim

Journal of Health Disparities Research and Practice

Background: There is a shortage of health data for Asian American (AA) populations. This shortfall may be improved through the involvement of AA-serving community-based organizations (CBOs).

Objectives: This study assesses the feasibility of and interest among CBOs in creating a AA community-based data registry.

Methods: Leaders of CBOs were interviewed to assess their current data collection framework and their attitudes towards a shared data registry.

Results: Qualitative analysis shows CBOs are active in data collection, find data to be instrumental to their mission, and are interested in contributing to a broader data registry.

Discussion: The inclusion …

Personal Internalization Of A Confederate Monument Removal Event Associated With Increased Depression, Anxiety, And Stress Among University Students, Erika M. Redding, Yucheng Hou, Riley E. Mulhern

Journal of Health Disparities Research and Practice

This study sought to determine the association between racialized events relating to the removal of a Confederate monument and mental health outcomes among students at a Southern state-university in the United States. After the removal of a Confederate monument located on the university’s campus, racialized protests and violent clashes with police forces ensued. To assess the impact of these events on student mental health outcomes, a cross-sectional survey was disseminated to 10,000 current students. Student mental health was measured using the 21-item Depression, Anxiety, and Stress Scale (DASS). The key exposure, personal internalization of the event, was measured using the …

Osteopathia Striata With Cranial Sclerosis: Genetic Diagnosis In A Rural Setting, Jithil L. Tharayil B.S., Joseph J. Thomas B.S., Sally S. Leong B.S., Megan L. Mosca B.S., Jose Cucalon Calderon M.D.

Journal of Health Disparities Research and Practice

Osteopathia striata with cranial sclerosis (OSCS) is a rare skeletal dysplasia inherited in an X-linked dominant pattern. Patients present with a wide variety of congenital anomalies such as craniofacial, cardiac, musculoskeletal, intestinal, and genitourinary abnormalities, and developmental delay. The genetic mutation causes increased ossification of bones which can compress cranial nerves and subsequently lead to acquired hearing loss, facial paralysis, and other neurologic defects. OSCS has also been associated with epileptic seizures, pyloric stenosis, hypothyroidism, and increased bone fragility. Due to the nonspecific presentation of conditions like OSCS and the serious complications it predisposes patients to, it is important that …

Us Immigrants’ Experiences With The Covid-19 Pandemic- Findings From Online Focus Groups, Awele Maduka-Ezeh, Ikwesilotuto T. Ezeh, Benjamin E. Bagozzi, Jennifer A. Horney, Somawina Nwegbu, Joseph E. Trainor

Journal of Health Disparities Research and Practice

Objective:

Immigrants in the United States (US) are disproportionately affected by disasters. Yet the effects of one type of disaster—pandemics—have been underexplored in this regard. The purpose of this study was to better understand these effects, with specific attention to the impacts of the COVID-19 pandemic on US immigrants and their social networks.

Design:

Forty-five US immigrants (aged 18 and above) participated across eight online focus groups during spring 2020. Using “criterion of inclusion” sampling, participants were recruited via gatekeeper and snowball sampling methods. Anonymity was maintained throughout all online focus group sessions. Discussions were transcribed and then categorized into …

Racial And Ethnic Disparities In Illinois Lung Cancer Incidence, Mortality Stage At Diagnosis, Surgical Treatment, And Screening, Ritika Golechha, Mickyas Hezekiel Eskender, David D. Odell, Joe Feinglass

Journal of Health Disparities Research and Practice

This study analyzes the extent of racial and ethnic disparities in lung cancer in Illinois as compared to national trends. Cancer registry data were used to compare lung cancer incidence, mortality and stage at diagnosis rates for non-Hispanic (NH) white, NH Black and Hispanic Illinois residents. Hospital discharge data were used to compare medical and surgical admission and screening rates. Smoking across race and ethnic groups was compared using data from the Illinois Behavioral Risk Factor Surveillance System to determine the extent to which disparities might be related to smoking prevalence. Rate ratios for NH Black and Hispanics compared to …

Disparities In Access To After-Hours Care In The U.S.: A National Study, Kavita Mosalpuria, Fernando A. Wilson, Mohammad Siahpush

Journal of Health Disparities Research and Practice

After-hours care provides timely access to continuity of care for chronic illnesses and episodic care for acute illness. Lack of timely access to primary care services is one of the main drivers of emergency department overuse. Our aim was to examine disparities in access to after-hours care based on race, income, geographic location, type of insurance, and health care setting. We used data from the 2010 Health Tracking Household Survey. Multivariable logistic regression was used to assess disparities in access to after-hours care. We found disparities by type of insurance, geographic location, and type of health care setting. People with …

The Association Between Cardiovascular Disease Knowledge And Risk Factors Among African American Breast Cancer Survivors In The Deep South, Michelle S. Williams, Chizoba Anyimukwu

Journal of Health Disparities Research and Practice

Purpose: African American breast cancer survivors in the Deep South have a disproportionately high burden of cardiovascular disease (CVD) mortality. Multiple potentially modifiable CVD risk factors are highly prevalent in this population, such as high blood pressure, obesity, and poor dietary habits. The purpose of this study was to assess the association between CVD health metrics and heart disease knowledge among the target population.

Methods: The Heart Disease Knowledge Questionnaire was used to assess the participants’ knowledge of heart disease and heart disease risk factors. Questions from My Life Check were used to assess the participants cardiovascular health metrics. Multivariate …

Environmentally Marginalized Populations: The "Perfect Storm" For Infectious Disease Pandemics, Including Covid-19, Gabriella Y. Meltzer, Oyemwenosa Avenbuan, Christina Awada, Oluwakemi B. Oyetade, Tricia Blackman, Simona Kwon Drph, Mph, Esther Erdei Phd, Judith T. Zelikoff Phd

Journal of Health Disparities Research and Practice

COVID-19 has exacted a severe toll on the United States population’s physical and mental health and its effects have been felt most severely among people of color and low socioeconomic status. Using illustrative case studies, this commentary argues that in addition to COVID-19 health disparities created by psychosocial stressors such as the inability to socially distance and access quality healthcare, environmental justice communities have the additional burden of disproportionate exposure to toxic contaminants that contribute to their higher risk of COVID-19. Environmental contaminants including heavy metals and persistent organic pollutants found contaminating their nearby environments can alter the immune response, …

Are Binge Drinking Disparities By Sexual Identity Lower In U.S. States With Nondiscrimination Statutes That Include Sexual Orientation?, Naomi Greene, Renee M. Johnson, Joanne Rosen, Danielle German, Joanna E. Cohen

Journal of Health Disparities Research and Practice

Purpose Studies examining binge drinking disparities by sexual identity focus on intra- and inter-personal minority stressors experienced by lesbian, gay, and bisexual (LGB) populations. State-level statutes are powerful tools that can reduce health disparities. We examined how state-level nondiscrimination statutes that include sexual orientation as a protected ground (i.e., inclusive statutes) are associated with binge drinking disparities between LGB and straight adults. Methods We combined data from the 2015-2018 Behavioral Risk Factor Surveillance System (BRFSS), the Movement Advancement Project (MAP), and administrative data sources for information on binge drinking, sexual identity, nondiscrimination statutes, and individual and state-level factors. We included …

The Impact Of Food Insecurity Screenings And Community Food Resource Referrals For Patients With Type 2 Diabetes, Miriam Ngozi Ofili, Robin M. Lawson

Journal of Health Disparities Research and Practice

ABSTRACT

Approximately 50 million people in the United States are food insecure, which makes food insecurity (FI) one of the country’s most prevalent health issues. Food insecurity has been shown to be a contributing factor to uncontrolled Type 2 Diabetes (T2D), which affects about 34.1 million adults in the United States. The purpose of this study was to evaluate the effectiveness of integration of an electronic social determinants of health screening and community referral process for adult patients with T2D and FI. The aim was to determine if Hemoglobin A1c (HbA1c) levels are reduced in adult patients with T2D by …

Risk Factors Associated With Opioid Use Among African American Faith-Based Populations, Kelsey Christensen Ma, Jannette Berkley-Patton Phd, Alexandria Bauer Phd, Carole Bowe Thompson, Tacia Burgin

Journal of Health Disparities Research and Practice

African Americans (AAs) in the Midwest are more likely to die from an opioid overdose compared to Whites, despite lower rates of use. Little is known about factors related to opioid use among AAs residing in the Midwest, particularly church-affiliated AAs. AAs have the highest rate of church attendance among all racial/ethnic groups, and the Black Church may be an appropriate setting for prevention efforts. The present study sought to better understand factors related to opioid use among Midwestern church-affiliated AAs to inform future faith-based interventions. This study examined predictors of opioid use (ever) using survey data from Taking It …

Gender Disparity In Composition And Compensation Among Maryland Hospital Executives, Gilberto O. Lobaton, Majd Marrache Md, Varun Puvanesarajah Md, Dawn M. Laporte Md, Amit Jain Md, Shruti Aggarwal Md

Journal of Health Disparities Research and Practice

Introduction: Senior executive positions in hospitals have traditionally been held by men, and do not reflect the gender, racial, ethnic, and cultural diversities of the communities they serve. Despite sex parity in medical school graduates, women remain underrepresented in hospital executive leadership positions. In this study, the authors examined differences in gender composition and compensation of Maryland hospital executives.

Methods: The authors examined 47 Maryland hospitals’ publicly available tax forms from 2013-2018. Data collected included hospital revenue and executive positions’ count, salary, and gender. Executive positions included President and/or Chief Executive Officer (P/CEO), Chief Financial Officer (CFO), Chief Medical Officer …

Propelling Adolescents Toward Careers In Healthcare (Patch): A Medical Student Led Pipeline Program For High School Students Underrepresented In Medicine, Maggie Brownrigg, Sagar Patel Md, Kyle Roedersheimer Md, Melissa Wooten Md, Radhika Ghodasara Md, Banks Kooken Md, Iris Cheng Md

Journal of Health Disparities Research and Practice

Despite the growing diversity of the United States population, individuals from many racial and ethnic minority groups and low-income families continue to be underrepresented in the health professions. A diverse healthcare workforce would improve cultural competency and create a system better suited to address the vast health disparities in many disadvantaged communities, yet the current educational pipeline needs to expand opportunities to provide students traditionally underrepresented in medicine (UIM) a path to become a part of the healthcare field. The Propelling Adolescents Towards Careers in Healthcare (PATCH) program was founded to address this gap in the current health professions pipeline …