Community Health Commons^™

Association Between Diagnosed Anxiety And Depression And Exposure To Life Stressors During The Covid-19 Pandemic, Emily Hallgren Phd, Don E. Willis Phd, Brett Rowland Ma, James P. Selig Phd, Pearl A. Mcelfish Phd

Journal of Health Disparities Research and Practice

Research suggests that mental health disorders heighten the risk of exposure to life stressors. Drawing on a sample of 754 adults from a survey distributed at six primary care clinics, we examine whether adults who reported ever being diagnosed with depression or anxiety were more likely to experience an employment disruption, a housing disruption, and/or report more COVID-19-related stressors during the COVID-19 pandemic. Individuals who reported ever being diagnosed with depression reported a greater burden (B=.75) of COVID-19-related stressors. Those who reported ever being diagnosed with anxiety had higher odds of experiencing an employment disruption (OR=1.90) and a housing disruption …

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, …

Employing Position Generators To Assess Social Capital And Health: A Scoping Review Of The Literature And Recommendations For Measurement In Future Population-Based Surveillance, Steven Meanley, Candice Biernesser, Teagen O'Malley, Todd Bear, Jeanette Trauth

Journal of Health Disparities Research and Practice

Beneficial social connections are critical to individual-level health because they can be used to avoid or minimize the risks and consequences associated with diseases. How to best measure beneficial social connections to inform social network-level health interventions remains poorly understood. A scoping review of health surveillance studies was conducted to highlight the utility of employing position generators to assess how access to beneficial social connections was associated with population health and disparities. Our review yielded 39 articles conducted across 14 predominantly high-income countries. Most studies (77%) with composite measures for beneficial social connections exhibited health-protective associations. Of the remaining articles, …

A Health Disparity Action Plan: Achieving Equity Through Clinical Trials, Affordable Care, And Professional Development, Daniel Schafer, Shefa Moten, Ayesha Khan, Mauro Ferrari, Boris Lushniak, Edwin Burkett, Asad Moten

Journal of Health Disparities Research and Practice

Given the threatened nature of affordable care in the United States, it is crucial to underscore its importance. What is more, the reason such care is so important is the presence of an oft-unacknowledged disparity in access to quality care in this country and, indeed, around the world. A world without health disparities can be achieved and will be characterized by prompt and quality care available to all and at all stages of the care continuum. Further insurance reform is needed beyond the Affordable Care Act, while local care must be more accessible in rural, urban, and other underserved areas. …

Does Age Affect The Association Between Race/Ethnicity And Hpv Screening: A Retrospective Cohort Study Of United States Women, Keila L. Marlin, Mph, Larissa R. Brunner Huber, Ph.D.

Journal of Health Disparities Research and Practice

Many studies have demonstrated disparities in awareness of and knowledge about human papillomavirus (HPV) among young, immigrant, and minority populations. Yet, there is a lack of existing research that has investigated the role of race/ethnicity and HPV screening, and how it varies by age. The purpose of this study was to evaluate this association using 2016 Behavioral Risk Factor Surveillance System (BRFSS) data. This study included 120,646 women who self-reported information on race/ethnicity, HPV screening, and age. Logistic regression was used to obtain odds ratios (OR) and 95% confidence intervals (CIs). A stratified analysis was conducted to determine if age …

Implementing Autism Screening For Latino Children In Primary Care: Perspectives From Parents And Providers, Mary Troxel, Keri Linas, Diane Jacobstein, Matthew Biel, Sandra H. Soto, Isabella Lorenzo-Hubert, Soraya Dos-Santos, Rocio Mendez, Bruno J. Anthony

Journal of Health Disparities Research and Practice

While Autism Spectrum Disorder (ASD) and other developmental disabilities are being diagnosed at increasing rates, there is strong evidence of disparities in rates of identification and utilization of services by Latino children as compared to non-Latino children. Attempts to reduce these disparities include culturally-informed early screening for ASD risk. In preparation for initiation of a screening program in a primary care setting serving primarily Latino children, focus groups and interviews were conducted with Latino parents (N=31), medical staff (N=15), health care providers (N=4) to better understand the barriers and facilitators to engagement around developmental concerns that contribute to the low …

Disrupting The Intergenerational Transmission Of Trauma Among Alaska Native People: A Conceptual Model For The Family Wellness Warriors Initiative, Lily Ray, Bobbi Outten, Polly Andrews, Katherine Gottlieb

Journal of Health Disparities Research and Practice

Background: Increasing evidence demonstrates the life-long physical, emotional, and social effects of traumatic experiences. In recognition that many health disparities are driven by high rates of traumatic experiences, Alaska Native and American Indian people have created wellness programs that build health by first healing historical and lifetime trauma. Yet, many of these promising community-based interventions are not described in the health sciences literature. Southcentral Foundation’s Family Wellness Warriors Initiative (FWWI) was created by Alaska Native people, addresses traumatic experiences as the root cause of family violence, and builds on cultural strengths. The goal of this study was to build a …

Exploring The Cultural Perceptions Of Physical Activity Among Transnational Nigerian Immigrants, Kelechi D. Ibe-Lamberts, Daudet Ilunga Tshiswaka, Abi Fapohunda

Journal of Health Disparities Research and Practice

Background: Transnational Nigerian Immigrants, as other Transnational African Immigrants, are a subset of African immigrants with the unique ability to sustain multi-national ties. These ties could potentially affect health behavior choices and participation in physical activity. Physical Activity has the potential to improve health and prevent chronic diseases; however, there is a lack of literature regarding physical activity and its determinants within the Transnational African Immigrant population in general. This study investigated the cultural factors that shape Transnational Nigerian Immigrants’ perceptions and attitudes towards physical activity.

Methods: Semi-structured, individual interviews supported by photo-elicitation were conducted on 24 Transnational …

Development Of A Culturally Appropriate Smokeless Tobacco Cessation Program For American Indians, Kathryn Rollins, Charley Lewis, T. Edward Smith, Ryan Goeckner, Jason Hale, Niaman Nazir, Babalola Faseru, K Allen Greiner, Sean M. Daley, Won S. Choi, Christine M. Daley

Journal of Health Disparities Research and Practice

This study describes a multiphasic approach to the development of a smokeless tobacco cessation program targeted for American Indians (AI) of different tribal nations. The authors gathered formative data from a series of focus groups and interviews to investigate the knowledge, attitudes, and beliefs of AI and smokeless tobacco (SLT) use. Predominant themes emerged from four major topic areas (SLT use, initiation and barriers, policy, and program development) across both studies. This study further assessed educational materials developed for the cessation program for scientific accuracy, readability, and cultural appropriateness. Program materials were scientifically accurate and culturally appropriate. The average corrected …

The Effects Of Childhood Social Support And Family Resiliency On Mental Health In Adulthood, Korede K. Adegoke, Chukwudi Ufondu, Dania Al Agili, Estrellita L Berry L. Berry, Hamisu M. Salihu

Journal of Health Disparities Research and Practice

The effect of social support on the overall health and quality of life in adulthood has been well documented particularly in chronic disease populations. Very few studies examined the relationships between childhood social support, family resiliency and mental health in adulthood in the community and among disadvantaged minority populations. We examined the role of social support and family resilience during childhood on subsequent mental health-related quality of life (HRQoL) in adulthood among racial/ethnic minorities.

A needs assessment survey which was designed to explore health determinants and quality of life indicators using a community-based participatory research (CBPR) approach in a low-income …

Knowledge And Beliefs About Cancer In African American Population, Rabindra P. Gautam Dhs, Deven Shah Phd, Eric Matthews Phd

Journal of Health Disparities Research and Practice

Cancer is the second most common cause of death in the United States, taking the lives of one in four Americans each year (American Cancer Society [ACS], 2015). A total of 1,658,370 new cancer cases and 589,430 deaths from cancer were projected to occur in the United States in 2015 (ACS, 2015). In 2013, approximately 176,630 new cancer cases and 64,880 deaths from cancer were projected to occur in African American communities. The majority of diagnoses were cancers of the prostate, lung, colon, rectum, breast, and colorectal region (ACS, 2013). For most cancers, African Americans have the highest death rate, …

The Effects Of Patient Characteristics On Clinician’S Adherence To Preventive Practice Guidelines, Deshana A. Collett Ph.D,Pa-C, Kenneth M. Tyler Ph.D.

Journal of Health Disparities Research and Practice

ABSTRACT

BACKGROUND: The existence of health disparities confirms that not all patients, regardless of differences in patient demographics, are provided quality healthcare (Agency of Health Care Research and Quality, 2003). Moreover, research suggests that health disparities may be present due to the inadequate delivery of medical services (S. Haist, J. Wilson, M. Lineberry, & C. Griffith, 2007; Van Ryn, Burgess, Malat, & Griffin, 2006). The differences in the delivery of care and services to ethnic minorities and those of low socioeconomic status warrant examining the role healthcare providers play in the causation of these health disparities (Smedley, Stith, & Nelson, …

Emergency Department Utilization: A Qualitative Analysis Of Illinois Medical Home Network Patients., Crystal M. Glover, Yanina A. Purim-Shem-Tov

Journal of Health Disparities Research and Practice

Background

Inappropriate emergency department (ED) use continues to plague healthcare in terms of disease management and costs. In 2012, the State of Illinois implemented Medical Home Network (MHN) where Medicaid recipients were assigned to primary care providers to, in part, reduce overreliance on EDs. However, MHN patients have continued to use EDs.

Objective

The purpose of this study is to provide a qualitative analysis of Medicaid patient-identified barriers to primary care, facilitators of emergency use, and related mental health and psychosocial factors.

Methods

Patients who presented themselves at the ED located at an urban, academic medical center participated in one-time, …

Addressing Health Disparities Among Homeless In Alachua County Through Community-Based Participatory Research., Meron Hirpa, Omar Iqbal, Haider Ali, Sama I. Ilyas, Nabeel Iqbal, Jeena A. Kar, Tiffany Splatt, Brendan Shortley, Nancy Hardt

Journal of Health Disparities Research and Practice

Introduction. In states such as Florida that did not expand Medicaid, a large number of economically disadvantaged individuals do not qualify for subsidies to buy health insurance through the Affordable Care Act (ACA) ². This leaves the health needs of Florida’s homeless population largely unaddressed. Nearly 48.1% of Alachua County’s homeless population has disabling conditions ¹⁶. This confirms a pressing need to understand the homeless population's healthcare needs, knowledge, and barriers in accessing healthcare. Methods. We used a Community-Based Participatory Research model in conducting health fairs and needs assessment surveys, incentivizing participation, and providing education about existing resources. …

Violence Against Pregnant Women With Disabilities, Ari K. Mwachofi

Journal of Health Disparities Research and Practice

Background

Each year, violence is perpetrated against 1.5 million US women, of whom 324,000 are pregnant. Violence in pregnancy has adverse effects on maternal and infant health. Although there are 4.7 million childbearing age women with disabilities, and their pregnancy rates are growing, there is very little information about violence against pregnant women with disabilities.

Objectives

The study questions are: Are there differences in pre- and in-pregnancy violence experiences of women with and without disabilities? Is disability a significant predictor of pre- and in-pregnancy violence against women?

Methods

The study uses data from the 2009 Pregnancy Risk Assessment Monitoring System …

Hawai‘I’S Caring Communities Initiative: Mobilizing Rural And Ethnic Minority Communities For Youth Suicide Prevention, Jane J. Chung-Do, Deborah A. Goebert, Kris Bifulco, Tasha Tydingco, Antonia Alvarez, Davis Rehuher, Jeanelle Sugimoto-Matsuda, Bridget Arume, Pohai Wilcox

Journal of Health Disparities Research and Practice

Youth suicide is a serious, yet preventable, public health concern for ethnic minorities and rural communities. This paper describes the youth leadership model utilized by Hawai‘i’s Caring Communities Initiative (HCCI) and provides reflections on the important factors for success in implementing a youth and community advocacy project for youth suicide prevention. HCCI partnered with six youth and community organizations who serve ethnic minority and rural communities across the State of Hawai‘i to train youth leaders and community members in suicide prevention, in order to develop community awareness activities that are grounded in each community’s strengths and needs. The work of …

Common Threads: An Integrated Hiv Prevention And Vocational Development Intervention For African American Women Living With Hiv/Aids, Liza Marie Conyers, Yung-Chen Chiu, Aisha Shamburger-Rousseau, Vanessa Johnson, Mark Misrok

Journal of Health Disparities Research and Practice

Current policies and initiatives call for the integration of social determinants of health into HIV/AIDS prevention and care interventions. According to the World Health Organization’s Commission on Social Determinants of Health, the lower a person’s socioeconomic status, the worse the health outcomes. One way to alleviate poverty among African American women with HIV/AIDS is to help foster their vocational development and economic empowerment. The National HIV/AIDS Strategy Implementation Plan specifically directs federal agencies to find ways to integrate people living with HIV/AIDS into broader employment initiatives. The purpose of this manuscript is to examine medical, psychosocial, financial/legal and vocational social …

Are There Gender Differences In Perceived Sexual Self-Efficacy Among African-American Adolescents?, Michelle L. Redmond, Rhonda K. Lewis

Journal of Health Disparities Research and Practice

Background: African American adolescents accounted for more than half of all HIV/AIDS cases in 2009. Behavioral Strategies are needed to help lessen the incidence of HIV/AIDS among this population.

Purpose: The aim of his study was to examine sexual self-efficacy practices and beliefs among African American adolescents. We also examined gender differences between African American adolescents to better understand their perceptions of sexual self-efficacy, condom use intention, and other safer sex practices and beliefs.

Methods: A cross-sectional study was conducted with 214 African American adolescents using survey instruments to examine their beliefs, perception and intentions on the use of condoms, …

Association Analysis Of Reported Attitudes And Culturally Competent Behavior Engagement Among Public Health Department Employees, Marla B. Hall Phd, Jeffrey J. Guidry Phd, E. Lisako Mckyer Phd, Corliss Outley Phd, Danny Ballard Phd

Journal of Health Disparities Research and Practice

Objective: The purpose of this research is to analyze the association of attitudes and beliefs on engaging in culturally competent behavior.

Design: Explorational case study of individuals employed within an urban public health department.

Participants: Employees (n=90) from four metropolitan clinical sites of an urban public health department located in the southwest region of the United States were solicited and recruited during a monthly staff meeting. This sample is representative of 84% of the total employees which is comprised of 107 individuals.

Main Outcome Measures: The Cultural Competence Assessment is designed to explore individual knowledge, feelings …

Primary Care Behavioral Health Consultation Reduces Depression Levels Among Mood-Disordered Patients, Bill Mcfeature, Thomas W. Pierce

Journal of Health Disparities Research and Practice

The purpose of this study was to examine the effects of behavioral health consultative services on levels of depressive symptoms in patients diagnosed with a mood disorder. Two-hundred fifty-one patients with a form of mood disorder completed the PHQ-9 screening tool for depression both before and after a treatment period lasting an average of three months, during which patients received behavioral health consultation services. Results showed that 49.8% of patients participating in this integrated behavioral health care program experienced improvements of at least 50% in PHQ-9 scores from pre- to post-test. Improvements in PHQ-9 scores of at least a five …