Public Health Commons^™

Unique Breast Cancer Features Within The Vietnamese Population, Polly Niravath, Melissa Bondy, Susan G. Hilsenbeck

Journal of Health Disparities Research and Practice

BACKGROUND: Breast cancer is known to be a heterogeneous disease across women, and even within individual tumors. However, relatively little is known about heterogeneity across cultures. There has been some evidence to suggest that Asian women are more likely to have HER2+ breast cancer than their Caucasian counterparts.

PURPOSE: The aim of this study was to further investigate the unique pattern of breast cancer incidence and subtype in the Vietnamese population.

METHODS: We retrospectively collected data on all Vietnamese women diagnosed with invasive breast cancer at the Lester & Sue Smith Breast Center in Houston, Texas over a four year …

Hiv Treatment Outcome Disparities: Using Web-Based Technology To Promote Adherence And Engagement With Care Among African American Patients, Eric Houston, Brenda Wolfe, Alexander K. Tatum, Monique Rucker, Norma Rolfsen, Maryanne Williams, Nancy Glick

Journal of Health Disparities Research and Practice

Ethnic minorities continue to be disproportionately affected by the HIV epidemic and those individuals living with the virus experience differential outcomes in treatment. Technology-based approaches have been used to address a variety of health problems, but few studies have focused on the application of these approaches in addressing HIV treatment disparities. Using a sample of African-American patients identified as lost to follow-up for HIV treatment (n=33), this study examined the feasibility and acceptability of a web-based program designed to assess and improve treatment engagement. Participants were randomly assigned to either the web-based assessment program or the control group. Measures of …

Overcoming Recruitment Challenges: A Pilot Study In Arab Americans, Nawar M. Shara, Sayf A. Yassin, Soleman H. Abu-Bader, Asqual Getaneh, Shaunagh Browning, Alexander Zeymo, Barbara V. Howard, Zeid Abudiab, Anas Shahrour, Jason G. Umans

Journal of Health Disparities Research and Practice

While diabetes prevalence and cardiovascular risk factors have been increasing among Arab populations worldwide, few studies of Arab Americans have been conducted because of the difficulty in recruiting Arab American participants. Cultural sensitivity and social awareness of different immigrant groups could ensure successful recruitment and retention in clinical studies. While the primary objective of our overall research project was to determine the prevalence of metabolic syndrome in Arab Americans, the focus of this article is to describe the methodology used to overcome challenges in recruiting and enrolling Arab Americans for a community-based study. We used novel methods, including open houses, …

Relationship Of Associated Cardiovascular Risk Factors And Chronic Kidney Disease With Participants Enrolled In The National Kidney Foundation Of Hawai'i Kidney Early Detection Screening (Keds) Program, Merle R. Kataoka-Yahiro, Victoria Page, Dongmei Li

Journal of Health Disparities Research and Practice

Objective The objective of this study was to further examine the relationship of associated cardiovascular risk factors and chronic kidney disease (CKD) with a large cross-sectional sample of Native Hawaiians, Japanese, Chinese, Filipino, and White participants who were enrolled in the National Kidney Foundation of Hawai'i Kidney Early Detection Screening (KEDS) program.

Methods Data for this cross-sectional study was collected between 2006 and 2009 from the National Kidney Foundation of Hawaii (NKFH). Nine hundred and fifteen participants who attended the NKFH KEDS program were 18 years and older, and residents of the State of Hawaii. Data included demographic information, clinical …

Race, Age, And Neighborhood Socioeconomic Status In Low Birth Weight Disparities Among Adolescent Mothers: An Intersectional Inquiry, Sheryl L. Coley, Tracy R. Nichols

Journal of Health Disparities Research and Practice

Introduction: Few studies examined socioeconomic contributors to racial disparities in low birth weight outcomes between African-American and Caucasian adolescent mothers. This cross-sectional study examined the intersections of maternal racial status, age, and neighborhood socioeconomic status in explaining these disparities in low birth weight outcomes across a statewide sample of adolescent mothers.

Methods: Using data from the North Carolina State Center of Health Statistics for 2010-2011, birth cases for 16,472 adolescents were geocoded by street address and linked to census-tract information from the 2010 United States Census. Multilevel models with interaction terms were used to identify significant associations between maternal racial …

Assessing Feasibility And Readiness To Address Obesity Through Policy In American Indian Reservations, Valarie Blue Bird Jernigan, Gail Boe, Carolyn Noonan, Leslie Carroll, Dedra Buchwald

Journal of Health Disparities Research and Practice

The Institute of Medicine and Centers for Disease Control and Prevention (CDC) have identified policy and environmental strategies as critical to the prevention and control of obesity. However such strategies are rare in American Indian communities despite significant obesity-related disparities. Tribal policymaking processes differ by tribal nation and are often poorly understood by researchers and public health practitioners, hindering the dissemination, implementation, and successful scale-up of evidence-base obesity strategies in tribal communities. To address these gaps in knowledge we surveyed 138 diverse stakeholders in two American Indian reservations to assess the feasibility of and readiness to implement CDC-recommended obesity policy …

An Examination Of Cultural Competence Training In Us Medical Education Guided By The Tool For Assessing Cultural Competence Training, Valarie Blue Bird Jernigan

Journal of Health Disparities Research and Practice

In the United States, medical students must demonstrate a standard level of “cultural competence,” upon graduation. Cultural competence is most often defined as a set of congruent behaviors, attitudes, and policies that come together in systems, organizations, and among professionals to enable effective work in cross-cultural situations. The Association of American Medical Colleges developed the Tool for Assessing Cultural Competence Training (TACCT) to assist schools in developing and evaluating cultural competence curricula to meet these requirements. This review uses the TACCT as a guideline to describe and assess pedagogical approaches to cultural competence training in US medical education and identify …

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

Journal of Health Disparities Research and Practice

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 …

Recruiting And Retaining Individuals With Serious Mental Illness And Diabetes In Clinical Research: Lessons Learned From A Randomized, Controlled Trial., Stephanie W. Kanuch M.Ed., Kristin A. Cassidy Ma, Neal Dawson Md, Melanie Athey Ms, Edna Fuentes-Casiano Mssw, Martha Sajatovic Md

Journal of Health Disparities Research and Practice

Abstract: Recruitment and retention of individuals with serious mental illness (SMI) and comorbid diabetes mellitus (DM) in research studies can be challenging with major impediments being difficulties reaching participants via telephone contact, logistic difficulties due to lack of transportation, ongoing psychiatric symptoms, and significant medical complications. Research staff directly involved in recruitment and retention processes of this study reviewed their experiences. The largest barriers at the macro, mediator, and micro levels identified in this study were inclement weather, transportation difficulties, and intermittent and inaccessible telephone contact. Barrier work-around practices included using the health system’s EHR to obtain current phone numbers, …

Reducing Disparities By Way Of A Cancer Disparities Research Training Program, Lee S. Caplan, Tabia H. Akintobi, Tandeca K. Gordon, Tiffany Zellner, Selina A. Smith, Daniel S. Blumenthal

Journal of Health Disparities Research and Practice

Background: For minority populations, there is a continuing disparity in the burden of death and illness from cancer. Research to address this disparity should be conducted by investigators who can best understand and address the needs of culturally diverse communities. However, minorities are under-represented in health-related research. The goal of this project was to develop and evaluate an approach to motivating and preparing master’s degree students for careers dedicated to cancer disparities research.

Method: A Cancer Disparities Research Training Program (CDRTP) was initiated in 2010. The program consists of coursework, practicum experiences, and research opportunities. Assessment of the curriculum is …

Acceptability And Feasibility Of Web-Based Diabetes Instruction For Latinos With Limited Education And Computer Experience, Sharon A. Fitzgerald, Victor E. Martinez-Zavala, Kenia Yazmin Reyna Blanco, A Paula Cupertino, Mugur V. Geana, Edward F. Ellerbeck

Journal of Health Disparities Research and Practice

Introduction: The internet offers an important avenue for developing diabetes self-management skills, but many Latinos have limited experience with computer-based instruction.

Objective: To evaluate the feasibility and acceptability of delivering a web-based diabetes education program in a computer classroom for Spanish-speaking Latinos.

Methods: Spanish-speaking Latinos (n=26) attended two classroom sessions to learn computer skills while navigating a web-based diabetes education platform. Diabetes knowledge was assessed before and after the intervention; structured interviews were completed to assess program acceptability.

Results: Half of participants (50%) had not previously used a computer. Post-intervention, diabetes knowledge improved significantly (p=.001). The majority of participants (86%) …

Building Community-Campus Partnerships To Prevent Infant Mortality: Lessons Learned From Building Capacity In Four Us Cities, Renata Schiavo, Isabel Estrada-Portales, Elena Hoeppner, Denisse Ormaza, Radhika Ramesh

Journal of Health Disparities Research and Practice

Infant mortality rate (IMR) is an important indicator of progress toward health equity and socio-economic development. Despite progress, the US is ranked 45th among 192 countries in IMR, with non-Hispanic black IMR 2.2 times that of non-Hispanic white rates, and higher than average IMR in Native American populations. The Preconception Peer Educators (PPE) program of the U.S. DHHS Office of Minority Health Resource Center (OMHRC) aims to raise awareness about IMR disparities in African Americans, and to promote preconception health behaviors among women of childbearing age and sexually active men. Building upon this program, this report focuses on lessons learned …

Depression Symptoms , Acculturation, Needing Care, And Receiving Care: A Study Of Adolescents Living In California, Shahrzad Bazargan-Hejazi, Mohsen Bazargan, Magda Shaheen, Senait Teklehaimnot, Alireza Ahmadi, Joan Cooper, Stacey Teruya

Journal of Health Disparities Research and Practice

Background: The objectives of this study are 1) to depict the prevalence of moderate depressive symptoms (MDS) in adolescents living in California, 2) to examine the role of acculturation in reported MDS, and 3) to identify any relationship between acculturation, “needing emotional help,” and “receiving psychological or emotional counseling,” as reported by adolescents with MDS. Methods: We analyzed data from a cross-sectional population-based telephone survey for adolescents who completed the California Health Interview Survey (CHIS) in 2007, 2009, and 2011-2012. The primary predictor variable was level of acculturation. Outcome variables were 1) the presence of MDS, 2) whether participants needed …

Healthcare Providers’ Perceptions Of Socioeconomically Disadvantaged Patients With Chronic Pain: A Qualitative Investigation, Nicole A. Hollingshead, Marianne S. Matthias, Matthew Bair, Adam T. Hirsh

Journal of Health Disparities Research and Practice

Socioeconomically disadvantaged individuals are at-risk for chronic pain and disparate care. In this qualitative study, we explored providers’ experiences with socioeconomically disadvantaged patients, with a particular focus on providers’: (1) perceptions of socioeconomically disadvantaged patients’ barriers to pain care, (2) attitudes towards this patient population, and (3) chronic pain decisions for these patients. Individual interviews were conducted with twenty-four healthcare providers. Providers discussed several patient-level access barriers, such as not having health insurance, financial constraints, and scheduling difficulties. Providers believed socioeconomically disadvantaged patients were at-risk to misuse prescription opioids and were less comfortable prescribing opioids to these patients. This investigation …

Brighter Sights: Using Photovoice For A Process Evaluation Of A Food Co-Op Style Nutrition Intervention, Margaret P. Raber, Kimberly Kay Lopez, Mike Pomeroy, Avni Mody, Christine Markham, Shreela V. Sharma

Journal of Health Disparities Research and Practice

Access to healthy food is a critical factor impacting childhood obesity. Brighter Bites is a school-based program that addresses the issue of fresh food access among low-income families living in food deserts using a food co-op model. The aim of this study is to evaluate initial parent participant reactions to the ongoing Brighter Bites program using Photovoice. A predominately Hispanic, economically disadvantaged, urban school was chosen as the site for the Photovoice project. A total of seven Brighter Bites parent participants were enrolled and six completed the study. The participants developed research questions, took documentary photographs, completed a group analysis …

Feasibility Of A Community-Based Sickle Cell Trait Testing And Counseling Program, Ashley Housten, Regina Abel, Terianne Lindsey, Allison King

Journal of Health Disparities Research and Practice

Background: Sickle cell trait (SCT) screening is required at birth in the United States; however, adults rarely know their SCT status prior to having children.

Purpose: Assess feasibility of a community-based SCT education and testing intervention.

Methods: Participants were recruited from eight community sites to complete an educational program and offered a hemoglobin analysis. A genetic counselor met individually with participants to discuss lab results.

Results: Between July 14, 2010 and May 31, 2012, 637 participants completed the educational program. Five hundred seventy (89.5%) provided a blood sample, and 61 (10.9%) had SCT or other hemoglobinopathies. The genetic counselor met …

Anticancer Effect Of Moringa Oleifera Leaf Extract In Human Cancer Cell Lines, María Del Mar Zayas-Viera, Pablo Vivas-Mejia, Ph.D, Jeyshka Reyes, Phd

Journal of Health Disparities Research and Practice

Many medicinal plants are used as chemo preventives and antitumor agents in numerous experimental models of carcinogenesis. Moringa oleifera is a plant that contains several phytochemicals, which have been used for medical purposes including anti-inflammatory, analgesic, metabolism activator, anti-asthmatic, anti-anemia, hormone-producing, liver protector, and detoxifier, among others. Moringa oleifera extracts have also been proposed as potential anticancer agents. Cancer is one of the main causes of deaths worldwide. Although many drugs exist against several types of cancer, more specific agents with lower side effects are necessary. Few reports exist regarding the antitumor activity of Moringa oleifera leaf extract in cancer …

The Role Of Sumo And Coilin In The Cajal Body, Shanya Whitehorse, Mario Izaguirre-Sierra, Phd

Journal of Health Disparities Research and Practice

Our lab is solely based on learning about the molecular biology of the cell nucleus using basic model organism such as plants and flies. We focus on the study of the Cajal Body (CB) and specifically, we are interested to know how nuclear bodies can be formed without a membrane. The CB and the nucleolus are conserved nuclear bodies in all eukaryotic cells. CBs contain multiple proteins and RNA species involved in many pathways such as splicing, ribosome biogenesis and telomere maintenance.

Coilin is one of the main proteins in the nucleus and it is known to be required for …

Addressing Diabetes Prevention At The American Indian Summer Medical Wellness Camp, Mahpiya Vanderbilt, Francine Gachupin, Phd, Mph

Journal of Health Disparities Research and Practice

American Indian youth ages 10-19 are nine times more likely of being diagnosed with type 2 diabetes compared to non-Hispanic whites. A family history of diabetes, being overweight, and being inactive are the main risk factors for type 2 diabetes. The American Indian Summer Medical Wellness Camp is a six day camp for American Indian youth where they are taught about nutrition and fitness in an effort to prevent diabetes. What I looked at is if students who have attended the camp in previous years make different choices than the youth who have never attended camp. I hypothesize that if …

Hiv-1 Vpr Causes Synaptodendritic Damage In Neurons, María A. Torres Rivera, Richard Noel, Jr., Phd, Bethzaly Velázquez-Pérez, Neysha Martínez-Orengo, Ms

Journal of Health Disparities Research and Practice

HIV weakens the immune system by infecting and destroying T-cells, leaving the body vulnerable to infection and the development of AIDS. Conventional treatments for HIV, such as combined anti-rectroviral therapy (cART), fail to prevent the development of HIV-associated neurocognitive disorder (HAND). Neurological dysfunction has been directly related to the invasion of HIV in the central nervous system (CNS). HIV produces neurotoxic proteins, such as the Viral Protein R (Vpr), which contribute to HAND. Astrocytes are the most abundant cells in the brain and an important HIV target. We hypothesize that astrocytes expressing Vpr will cause neuronal damage in our co-culture …

Protein Expression Of Steroid Receptors In Macaca Mulatta Endometriotic Lesions, Héctor Torres, Lynette Ruiz, Phd, Olga Gonzalez, Dvm, Luisa Morales, Drph

Journal of Health Disparities Research and Practice

Endometriosis is pathologically defined as the presence of endometrial tissue in ectopic locations. Currently, there are no specific, non-invasive biomarkers and no cure for endometriosis. Non-human primates (NHP), including Macaca mulatta (rhesus macaques), have been highlighted as appropriate models to study endometriosis due to genetic, physiological, and anatomical similarities to humans. Research shows endometriosis might be associated with molecular deviations in human peritoneal endometriosis, such as increased levels of estrogen receptors and decreased levels of progesterone receptors.

The aim of this study is to determine protein expression of steroid receptors in five endometriotic lesions of rhesus macaques. We propose that …

Polymer Antimicrobial Synergy Research, Samuel Smith, Charles V. Rice, Phd

Journal of Health Disparities Research and Practice

Recent studies have shown that certain polymers, such as branched polyethylenimine (BPEI), have the potential to be antimicrobial. We have been growing certain strains of Bacillus subtilis (B. subtilis) and Escherichia coli (E. coli) and adding in concentrations of ampicillin to find the minimum inhibitory concentrations (MICs). This allows us to add in different concentrations of BPEI to test for synergy between our antibiotic and our polymer.

To find the MIC of each antibiotic, we grew an overnight of the bacteria in Lysogeny Broth (LB) and let it inoculate for 20 hours. We then inoculated a 24 well culture cluster …

Mt1a Mrna Expression In Human Lung Cells (Beas 2b) After Airborne Pm10 And Copper Exposure: A Possible Biomarker For Asthma, Mariela Rosa-Casillas, Noé Crespo-Hernández, Bs, Mario Ortiz-Martínez, Braulio Jiménez-Vélez

Journal of Health Disparities Research and Practice

Puerto Ricans have the highest prevalence, morbidity and mortality of asthma than any other ethnic group in the U.S. and can be triggered by different stimuli such as airborne Particle pollution (PM). PM transfers transition metals, including cooper, to the human airways generating reactive oxygen species (ROS). Metallothionein protein (MT1A) is a free radical scavenger expected to be induced in lung cells by PM exposure; however, this has never been proven nor demonstrated. The hypothesis involves the amounts of PM₁₀ in 2004, which would be significantly higher in the urban sites during months of March and June, thereby increasing …

Indirect Elisa For Detection Of Fascioliasis Igg Antibodies In Human Sera, Ernesto R. Ramos Maldonado, Ana M. Espino, Phd

Journal of Health Disparities Research and Practice

Currently, coprological examination based on egg detection in stool samples is used as the most ideal standard for the diagnosis of human fascioliasis. However, this method has been proven not to be adequate when being employed in the acute phase of the disease, and presents a poor sensitivity during the chronic phase. Serodiagnosis has become an excellent alternative to coprological examination in efforts to combat the effects of fascioliasis on human and animal health. Human fascioliasis is usually recognized as an infection of the bile ducts and liver caused by Fasciola hepatica, known to affect over 2 million humans.

In …

Investigating The Role Of The Retinoblastoma Protein In The Expression Of Immunosuppressive Factors, Felipe Pérez Deliz, Pedro Santiago-Cardona, Phd, J. González, Phd, Jaileene Pérez-Morales, Meng

Journal of Health Disparities Research and Practice

Lung cancer remains one of the deadliest types of cancer, causing approximately 160,000 deaths per year in the US alone. Because of its poor detection techniques and highly invasive abilities, conventional treatments -such as radiation and chemotherapy- fail to improve long-term survival of patients. At the moment, the 5-year survival rate for all stages of lung cancer is only 16%. Recent breakthroughs in cancer research establish immunotherapy, which involves the stimulation of the immune system to target and attack cancer cells, as a highly promising alternative treatment against this deadly disease. However, the efficiency of this treatment varies on each …

Protein-To-Lipid Ratio Of Meibum As A Metric For Meibomian Gland Dysfunction, Isabel Ortiz, Eric Potma, Phd

Journal of Health Disparities Research and Practice

Dry eye disease is a condition caused by inadequate moisture levels in the eye that may result from one of two prevalent situations: reduced tear production, or imbalance in tear composition. The imbalance specific to deficiencies in the fatty, outer layer of the tear film is known as meibomian gland dysfunction. Meibomian glands secrete an oily substance, meibum, which slows the evaporation of the aqueous layer of the tear film. It is believed that the chemical composition of the meibum is directly related to its ability to keep the eye at healthy moisture. In analyzing the composition of meibum samples …

The Use Of Internal Combustion Boat Motors On Lakes On The Menominee Reservation, Dante Kaquatosh, Joshua Pyatskowit, Phd

Journal of Health Disparities Research and Practice

Introduction: The use of boat motors on lakes is allowed on some but not all lakes. Does the use of motorized boats have an effect on the quality of water?

Objective or Hypotheses: We will investigate the water quality in lakes to determine if there is a difference in water quality due to boat motors. We hypothesize that lakes where boat motors are allowed will have lower water quality than lakes where boat motors are not allowed.

Methods: Four different water quality parameters were measured (pH, Alkalinity, Hardness and Conductivity), from six different lakes. Water samples were taken from each …

Polychlorinated Biphenyls And Metabolic Diseases On St. Lawrence Island, Alaska, Jasmine Jemewouk, Pamela Miller, Ms, Phd

Journal of Health Disparities Research and Practice

Polychlorinated Biphenyls (PCBs) are industrial chemicals that were used from 1929 until 1979 as a plasticizer in paints, plastics, and rubber products. However, PCBs continue to persist in the Arctic. They enter the Arctic environment through air and ocean currents. Sunlight and weathering help break down chemicals, so the Arctic’s lack of sunlight and precipitation during the winter allows PCBs to more readily accumulate. These chemicals settle either on organic films or water and are consequently absorbed by the Arctic food web. PCBs then bioaccumulatep in fatty tissues like omega-3 fatty acids. The higher the animal is in the food …

Localization Of Fulicin-Like Immunoreactivity In The Central Nervous System And Periphery Of Biomphalaria Glabrata, An Intermediate Host For Schistosomiasis, Anthony Hernandez-Vasquez, Mw Miller, Phd, S Rolon-Martinez, Bs, Lo Vaasjo, Bs, Mb Rodriguez

Journal of Health Disparities Research and Practice

An estimate of about ten percent of the population worldwide live at risk of contracting the parasitic disease schistosomiasis, or “snail fever”. The digenetic trematode worm species Schistosoma mansoni that is responsible for causing the most common form of intestinal schistosomiasis requires the freshwater snail Biomphalaria glabrata to serve as its primary intermediate host, where it multiplies and develops into its cercarial form that is infectious to humans. Parasitic castration and parasitic gigantism are among some of the profound behavioral changes that the infection of B. glabrata by S. mansoni is known to cause. For this reason, a neural transcriptomics …

The Contributions Of Skeletal Muscle Pkc Theta To Diet-Induced Obesity, Erika Harness, Joseph S. Marino, Phd, Yvette Huet, Phd

Journal of Health Disparities Research and Practice

Protein Kinase C- Theta (PKCθ) is a gene predominantly expressed in hematopoietic cells and skeletal muscle. In skeletal muscle, PKCθ regulates fat metabolism and insulin sensitivity. PKCθ activity increases in response to high levels of diacylglycerol in the cell, a common outcome of chronic high fat diet consumption and obesity. PKCθ is associated with skeletal muscle metabolic dysfunction, which may exacerbate weight gain and metabolic disease. The purpose of this study was to test the hypothesis that the selective deletion of PKCθ from skeletal muscle protects against diet-induced obesity.

Mice lacking PKCθ in skeletal muscle were created using Cre-Lox recombination. …