Social and Behavioral Sciences Commons^™

Does Using Sofa Score For Ventilator Triage Among Covid 19 Patients Result In Suboptimal Allocation Of Medical Ventilators For The Bipoc Population?, Alexandrea Mp Masocco, Elisabeth Michel, Ebbin Dotson

Journal of Health Disparities Research and Practice

Introduction: Since the COVID-19 pandemic in the United States, Black, and Latinx populations have been disproportionately affected by the COVID-19 pandemic. It can be inferred with high confidence that those most vulnerable are the least likely to receive essential care. Kidney transplant allocation and COVID-19 triage protocols share commonalities in that both protocols involve using multivariate scored criteria with objective and subjective inputs. As such, the similar conclusion in outcomes is concerning. It is worth questioning whether the racial inequalities demonstrated in the COVID-19 pandemic related to access to life-saving ventilators were associated with triage protocols.

Methodology: Using an exploratory …

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 Early Impact Of The Affordable Care Act Upon Colorectal Cancer Screening Utilization In Florida, Aldenise P. Ewing, Laura Baum, Rosalyn Roker, Marlene Joannie Bewa, Tali Schneider, Claudia F. Parvanta, Clement K. Gwede, Cathy D. Meade, Dinorah Martinez Tyson

Journal of Health Disparities Research and Practice

Background: Colorectal cancer is the second leading cause of cancer-related deaths in the United States. Although preventable and curable through screening, early detection and treatment, a lack of health insurance is a major obstacle to receiving colorectal cancer screening (CRCS). Despite the Affordable Care Act (ACA) increasing access to health insurance by mandating coverage of CRCS, disparities in utilization rates continue. Therefore, researchers sought to better understand ACA related facilitators and impediments that affect the utilization of CRCS and collect specific recommendations from healthcare professionals to increase screening utilization rates in Florida.

Methods: Researchers conducted in-depth interviews with …

A Lung Cancer Screening Personalized Decision-Aid Improves Knowledge And Reduces Decisional Conflict Among A Diverse Population Of Smokers At An Urban Academic Medical Center, Madeline Kaufman, Nilan Schnure, Andrea Nicholson, Frank Leone, Carmen Guerra

Journal of Health Disparities Research and Practice

Introduction: Few lung cancer screening decision aids have been tested in diverse populations. The study objective was to determine whether the online decision aid www.shouldiscreen.com impacts knowledge of and decisional conflict around lung cancer screening in a diverse population.

Methods: Eligible patients had significant smoking histories, were at increased risk for lung cancer (ages 45-80, >20 pack-years, smoking within last 15 years) and had no history of prior lung cancer or screening. Data was collected and analyzed in 2017.

Results: 40 patients were enrolled: 80% were female, 62.5% black, 33% white, and 48% had a high school …

Perceptions And Determinants Of Partnership Trust In The Context Of Community-Based Participatory Research, Arelis Moore De Peralta, Julie Smithwick, Myriam E. Torres

Journal of Health Disparities Research and Practice

Trust is difficult to conceptualize and define because of its diverse applications in different disciplines. Historic mistrust between vulnerable communities and researchers based on past adverse experiences can negatively affect the ability to collaborate and conduct effective research with such populations. Community Based-Participatory Research (CBPR) is a collaborative approach to research that can reduce historic mistrust and health disparities among minority populations. Although how trust development occurs in CBPR partnerships has been explored, there is a need to determine how to move from one stage to the next in fostering and maintaining that trust. The present study contributes to this …

Knowledge, Motivations And Concerns About Participation In Breast Cancer Clinical Trials In Puerto Rico, Marinilda Rivera-Díaz, Angélica N. García-Romero, Alelí M. Ayala-Marín, Camille Vélez-Alamo, Adrianna I. Acevedo-Fontánez, Mariana Arévalo, Vivian Colón-López

Journal of Health Disparities Research and Practice

Clinical trials (CT) in breast cancer have been crucial for new treatment discoveries. While participation in cancer CT is low, minorities are particularly underrepresented.This study aimed toidentify factors influencing the participation in CTs based on the experiences of Latina breast cancer survivors in Puerto Rico (PR), especially their CT knowledge, motivations, and concerns.Method:Focus groups (FG) were conducted by two social workers and the University of Puerto Rico/MD Anderson Community Health Educator. Participants were stratified into two subgroups: a) women with CT experience and b) those without CT experience. Seven FG were completed among breast cancer survivors (n=34) at …

The Right To Vote, The Right To Health: Voter Suppression As A Determinant Of Racial Health Disparities, Anna K. Hing

Journal of Health Disparities Research and Practice

Civic participation is beneficial to one’s health. Conversely, being unable to participate, such as being unable to vote, may be detrimental for health. Barriers that prevent voting and civic participation, which constitute voter suppression, disproportionately impact people of color. Therefore, voter suppression may explain intractable racial health disparities. However, few studies have examined the connection between voter suppression and health. In consideration of the frequent, and increasing, reports of voter suppression in recent elections, including the rise in voter identification laws, the reduction in early voting opportunities, and the closing of polling places, the field of public health should address …

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. …

Context Matters: Construct Framing In Measures Of Physical Activity Engagement Among African American Women, Stephanie M. Mcclure, Travis Loux, Enbal Shacham, Eileen Gillespie, Denise Hooks-Anderson

Journal of Health Disparities Research and Practice

Assessment of psychosocial factors influencing health behavior typically privileges conceptual consistency (framing constructs similarly across contexts) over conceptual specificity (context-specific framing). Modest statistical relationships between these factors and health behaviors, and persistent racial disparities in health outcomes raise questions about whether conceptually consistent framing fully captures relevant predictors. Ethnographic studies suggest not - that perceptions influencing health behaviors are multifaceted and contextual. To test this, we added items querying contextualized predictors of intention to engage in leisure-time physical activity (LTPA) to a Theory of Planned Behavior (TPB)-based survey and examined the psychometrics of the adapted subscales. We measured internal consistency …

Building Health Equity One Institution At A Time: The Research Infrastructure In Minority Institutions Project, Laura H. D'Anna, Dennis G. Fisher, Lyka Eunice F. Trinidad, Carol Canjura, Jefferson L. Wood

Journal of Health Disparities Research and Practice

Developing a well-trained workforce interested in, and prepared for, conducting health equity research is an important national priority. Scientists from Minority-Serving Institutions (MSIs) bring unique perspectives and experiences with racial, ethnic and social inequities in health and health status but often lack access to training and mentoring opportunities, which is crucial for increasing the diverse pool of investigators who are adequately prepared to conduct health disparities research and to compete for National Institutes of Health research funding. The focus of the California State University, Long Beach (CSULB) Research Infrastructure in Minority Institutions (RIMI) Project was to: (a) enhance CSULB’s infrastructure …

Predictors And Missed Opportunities For Blood Glucose Screening Among African Americans: Implications For Church-Based Populations, Alexandria G. Bauer, Jannette Berkley-Patton, Carole Bowe Thompson, Kelsey Christensen

Journal of Health Disparities Research and Practice

African Americans (AAs) are disproportionately diagnosed with prediabetes, diabetes, and related complications. Guidelines for prediabetes/diabetes screening emphasize reaching at-risk adults. The AA church has potential to increase reach of BGS with AA church members and community members. The current study identified predictors of blood glucose screening (BGS) and individuals with missed opportunities for BGS among church-affiliated AA adults. Participants were drawn from a previous pilot study (Project Faith Influencing Transformation) conducted in six AA churches over eight months. Eligibility criteria included self-identifying as AA and being aged 18 or older. Participants who had previously been diagnosed with diabetes were excluded, …

Factors Associated With Participation In The Oregon Summer Food Program: A Mixed Methods Analysis, Alethea Chiappone, Teresa M. Garvin, Casey Blaser, Hollyanne E. Fricke, Lisa Weissenburger-Moser Boyd, Tom Barnard, Amy L. Yaroch

Journal of Health Disparities Research and Practice

The Summer Food Service Program (SFSP) was established to ensure children eligible for the National School Lunch Program (NSLP) continue to receive meals outside of the school year. However, participation in SFSP is relatively low (2.8 million annually) when compared with NSLP participation (30.4 million annually), suggesting that challenges exist in reaching children. Using a mixed methods approach, this study explored factors associated with SFSP participation. A secondary data analysis of the Oregon SFSP identified factors associated with SFSP participation at the Oregon SFSP-, sponsor-, and site-levels. Semi-structured interviews with SFSP sponsors explored barriers and facilitators to SFSP participation. Results …

The Life She Deserves: Medical Marijuana In The United States, John Hudak, George Burroughs, Maritza Bermudez

Brookings Scholar Lecture Series

Brookings Mountain West offered an event titled, "The Life She Deserves: Medical Marijuana in the United States on Monday, November 5, 2018. This event featured a viewing of the film, and was followed by a panel discussion with John Hudak, George Burroughs, and Maritza Bermudez. “The Life She Deserves” is an intimate portrait of Jennifer Collins and her family’s struggle to find a treatment to control her debilitating epilepsy. Because her legal pharmaceutical treatments cause severe side effects, Jennifer and her mother move across the country to access medical marijuana. The therapy provides Jennifer and her family with the relief …

Promoting Community And Population Health In Public Health And Medicine: A Stepwise Guide To Initiating And Conducting Community-Engaged Research, Scott D. Rhodes, Amanda E. Tanner, Lilli Mann-Jackson, Jorge Alonzo, Florence Siman, Eunyoung Y. Song, Jonathan Bell, Megan B. Irby, Aaron T. Vissman, Robert E. Aronson

Journal of Health Disparities Research and Practice

Various methods, approaches, and strategies designed to understand and reduce health disparities, increase health equity, and promote community and population health have emerged within public health and medicine. One such approach is community-engaged research. While the literature describing the theory, principles, and rationale underlying community engagement is broad, few models or frameworks exist to guide its implementation. We abstracted, analyzed, and interpreted data from existing project documentation including proposal documents, project-specific logic models, research team and partnership meeting notes, and other materials from 24 funded community-engaged research projects conducted over the past 17 years. We developed a 15-step process designed …

Alternative Financial Services And Health Status In U.S. Metropolitan Statistical Areas, Courtney Hundley, Richard W. Wilson 8520196, John Chenault

Journal of Health Disparities Research and Practice

Abstract

Alternative financial services (AFS) such as, payday lenders, pawn brokers, tax refund loans, and check cashers are more prevalent in minority and lower income neighborhoods. These are neighborhoods also found to have disparities in health, compared to more affluent neighborhoods and communities. The focus of this paper is to determine if any relationship exists between use of AFS and health disparities.

Using data from a survey performed by the Federal Deposit Insurance Corporation (FDIC), we compared four banking variables to several measures of health for 85 metropolitan statistical areas (MSA) across the nation. The four banking variables all related …

Perceptions Of Chronic Disease Among Older African Americans: A Qualitative Analysis, Karon Phillips, Charles Rogers, Adrienne Morgan

Journal of Health Disparities Research and Practice

Research has documented that African Americans suffer disproportionately from chronic diseases when compared to the general population. Yet, limited research examines older African Americans’ perceptions about having chronic diseases. Accordingly, the first aim of the study provided insight into this disparity with the intent of revealing how older African Americans feel about their overall health, and how much they understand about their individual chronic disease(s). The second aim was to gather information about strategies and coping mechanisms older African Americans use to manage their chronic diseases. The purpose of this aim was to determine if any of the strategies they …

An Ambivalent Embrace: Service Needs And Gaps For Asian Immigrants In New Destinations, John J. Chin

Journal of Health Disparities Research and Practice

Asian immigrants to the U.S. are settling in "new destinations," but there has been little research on their health care and social service needs. Our analysis of Census data to identify cities with the fastest Asian immigrant population growth (1990-2000) yielded 33 smaller cities in 13 states. The cities ranged in population from 7,677 to 86,660; were spread across 13 states in the Northeast, South, and Midwest regions of the US; and varied widely demographically. Pilot surveys conducted in 2009 indicated that, although many residents had positive attitudes towards immigrants, many were also concerned about job competition and dilution of …

Pilot And Feasibility Test Of An Implementation Intention Intervention To Improve Fruit And Vegetable Intake Among Women With Low Socioeconomic Status, Michele A. Debiasse Phd, Rdn, Deborah J. Bowen Phd, Sherry L. Pagoto Phd, Joseph M. Massaro Phd, Nawfal Istfan Md, Phd, Lisa M. Quintiliani Phd, Rd

Journal of Health Disparities Research and Practice

Fruit and vegetable intake (FVI), a modifiable risk factor for chronic diseases, is lower in low socioeconomic status (SES) populations. Implementation intentions (a specific type of planning that extends the Theory of Planned Behavior) has been studied to improve FVI, but not exclusively with low SES groups. Using mixed methods, we evaluated the feasibility, acceptability, and preliminary efficacy of an implementation intention intervention (versus a general plan) to increase FVI in women with low SES. For the pilot randomized controlled trial, demographics, body mass index, attitude, perceived behavioral control, goal intention strength, and FVI were measured at baseline and FVI …

Priority Hypertension Management Strategies For At-Risk African Americans As Perceived By Medical Clinicians And Academic Scholars, Shirley M. Timmons, Lu Shi, Amin Khademi

Journal of Health Disparities Research and Practice

African American adults, in the United States (US), bear the greatest burden of high blood pressure (HBP)--a primary risk factor for cardiovascular disease and premature death. Current research does not adequately inform the design of multi-level interventions that work to control HBP in this at-risk population. The purpose of this study was to uncover information about priority strategies recommended for HBP control in African American adults. Research questions are 1) what are factors that reduce or manage HBP in at-risk African Americans and 2) what factors are important to the design and implementation of successful HBP interventions in at-risk African …

Identifying Corners Stores As The Future Of Healthy Food Access In African American Communities, Victor Romano, Jennifer Lee, Elliott Royal, Katherine Metzo, William Ruth, Theodore Hartsook

Journal of Health Disparities Research and Practice

For many people, the corner store remains the main grocer, or the only source of sustenance in minority communities. This study examined the distribution of corner stores as a future reference point to provide healthy food access to predominantly African American communities that lack full service grocery stores. Business data was obtained from respective county by use of Standard Industrial Codes. Each corner store was then categorized by either being Full Service (Stores that sell fresh produce, fresh meat, fresh dairy, and processed foods) or Non-Full Service (stores that do not sell all four categories of foods included in the …

Exploring The Life Course Perspective In Maternal And Child Health Through Community-Based Participatory Focus Groups: Social Risks Assessment, Abraham Salinas-Miranda, Lindsey M. King, Hamisu M. Salihu, Estrellita "Lo" Berry, Deborah Austin, Susan Nash, Kenneth Scarborough, Evangeline Best, Lillian Cox, Georgette King, Carrie Hepburn, Conchita Burpee, Eugene Richardson, Marlo Ducket, Richard Briscoe, Julie Baldwin

Journal of Health Disparities Research and Practice

Little is known about the patterns of risk factors experienced by communities of color and how diverse community contexts shape the health trajectory of women from the early childhood period to the time of their pregnancies. Thus, we conducted a focus group study to identify social risks over the life course that contribute to maternal and child health from the perspective of community members residing in low income urban areas.

Ten community-based participatory focus groups were conducted with residents from selected communities in Tampa, Florida, from September to November 2013. We used the life course perspective to illuminate and explain …

Sociocultural Risk Factors For Elevated Perceived Stress Among African American Smokers, Monica Webb Hooper, Noella A. Dietz, Joseph C. Wilson

Journal of Health Disparities Research and Practice

Introduction: African Americans experience unique stressors that may inhibit smoking cessation and enhance relapse rates. Few studies, however, have focused on risk factors for perceived stress among treatment seekers. Because African Americans are less likely to quit compared to the larger community, understanding factors associated with perceived stress among smokers has the potential to improve intervention outcomes. This study examined psychosocial and cultural correlates of stress in a sample of African American participants in a randomized controlled trial.

Methods: At baseline, participants reported demographic factors and completed assessments of smoking history, alcohol use, friend and household smoking, weight concerns, acculturation, …

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 …

The Construct And Predictive Validity Of Psychosocial Correlates Of Television Viewing, Raheem Paxton, Pascal Jean-Pierre, Saehwan Park, Yong Gao Dr., Stephen Herrmann, G J. Norman

Journal of Health Disparities Research and Practice

Background: Many studies have examined the consequences of prolonged television viewing, but few studies have examined the psychological states that contribute to this behavior. In this study, we evaluated the construct and predictive validity of psychosocial correlates of television viewing in a population of African American (AA) breast cancer survivors (BCS).

Methods: AA BCS (N = 342, Mean age = 54 years) completed measures of decisional balance, self-efficacy, family support, and time spent watching television online. Exploratory structural equation modeling (ESEM) was used to examine the construct and predictive validity as well as the differential item functioning of the instruments …

Assessment Of The Perceived Role And Function Of A Community Advisory Board In A Nih Center Of Excellence: Lessons Learned, Margaret L. Walsh, Desiree Rivers, Maria Pinzon, Nina Entrekin, Emily M. Hite, Julie A. Baldwin

Journal of Health Disparities Research and Practice

Background: The Community Advisory Board (CAB) was a vital component of the Center for Equal Health. The center addressed health disparities through community-based research and educational outreach initiatives. Objectives: To evaluate the perceived relationship of the CAB and Center, explore members’ perceptions of the CAB’s role, and elicit feedback on how to enhance the relationship between the Center and the CAB. Methods: Ten in-depth, semi-structured interviews were conducted. All interviews were transcribed verbatim and analyzed with a focus on predetermined codes. Results: Main themes focused on perception of CAB roles and need for utilization of board members; overall center challenges; …

The Feasibility Of Delivering A Home-Based Motivational Exercise Program To African-American Breast Cancer Survivors, Denise Spector, Claudio Battaglini

Journal of Health Disparities Research and Practice

Most African-American breast cancer survivors do not meet current exercise recommendations for cancer survivors, which include both aerobic and strength-training exercises. This pilot study tested the feasibility of delivering a home-based exercise intervention to African-American breast cancer survivors. Sedentary African-American breast cancer survivors were recruited for a 16-week motivational home-based progressive aerobic and strength-training exercise pilot study. Participants completed weekly exercise logs and received weekly phone calls. To assess feasibility, we evaluated recruitment, retention, and adherence rates, as well as participant acceptance and safety. 17 women enrolled; 13 completed the intervention (76%). Participants had moderately-high adherence (70%) to walking goals, …

Chronic Physical Health Conditions Among Homeless, Nooshin Nikoo, Marjan Motamed, Mohammad Ali Nikoo, Verena Strehlau, Erika Neilson, Sahoo Saddicha, Michael Krausz

Journal of Health Disparities Research and Practice

ABSTRACT

Objective: Morbidity and mortality among homeless individuals is higher than the general population. This study aims to determine the prevalence of current self-reported, chronic physical health conditions in a large sample of homeless people with sub-samples from shelters and street in British Columbia, Canada. Methods: Cross-sectional survey applying modified version of the ‘National Survey of Homeless Assistance Providers and Clients (NSHAPC)’ questionnaire in multiple sites in Vancouver, Victoria and Prince George, British Columbia, Canada. Sample: Five hundred homeless individuals were surveyed between May and September of 2009. A person was defined as homeless if he/she had a …

The Role Of Relationship And Other Factors Associated With Condom Use Intention Among Young American Indian Men Ages 18 To 24 Years Old, Rebecca Dick, Elizabeth Rink, Kris Fourstar

Journal of Health Disparities Research and Practice

The purpose of this study was to investigate the heterosexual relationship factors that were associated with condom use intention for STI prevention in a purposive sample of American Indian men. The sample was drawn from the Fort Peck Reservations in northeastern Montana. The sample size included 122 American Indian men ages 18 to 24. The theory of planned behavior and interdependence theory provided the theoretical basis for the study. Seventy- seven percent of the young men reported being in a steady relationship with 60.3% agreeing that they were committed to maintaining their relationship with their current partner. Relationship duration and …

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, …

Developing An Action Learning Community Advocacy/Leadership Training Program For Community Health Workers And Their Agencies To Reduce Health Disparities In Arizona Border Communities, Kenneth A. Schachter Md, Mba, Maia Ingram Mph, Laurel Jacobs Drph, Mph, Hannah Hafter Mph, Jill Guernsey De Zapien Ba, Scott Carvajal Phd, Mph

Journal of Health Disparities Research and Practice

Community health workers (CHWs) make unique and important contributions to society. They serve as patient advocates, educators, and navigators in our health care system and a growing body of research indicates that they play an important role in the effective delivery of prevention and treatment services in underserved communities. CHWs also serve as informal community leaders and advocates for organizational and community change, providing valuable insiders' insights about health promotion and the interrelatedness of individuals, their community, its institutions, and the surrounding environment. Accion Para La Salud or Action for Health (Accion) is a CDC-funded community based participatory research (CBPR) …